PERCUTANEOUS DISCECTOMY

Hernia is a common disorder that occurs when the intervertebral discs nucleus pulposus becomes dislodged from its natural position inside the annulus fibrosus. Most annulus fibrosus lesions are the result of repeated microtraumas of or a major trauma that degenerates to allow the nucleus pulposus to bulge and compress the spinal cord or a nerve, causing pain in the back and in the legs. When conservative treatment fails and symptoms persist or worsen, surgical treatment is considered.

With Diskom pressure on both spinal cord and nerve roots can be significantly reduced by removing disc herniation through a minimally invasive procedure.

Diskom is made up of two elements: an access needle with both distal and side openings, and a titanium choclear tip for the mechanical removal of the nucleous polpous. The great advantage of this device is that the cochlea is tightly connected, so it is almost impossible for it to detach: this is an advantage that is surely a unique feature of this system.

It is a mechanical removal procedure. It does not make use of either radiofrequency or laser. The wide side opening enables to remove up to 2cc of disc material. The basic principle uses an Archimedes’ screw or cochlea. The Archimedes’ screw works best with fluidor granular material. If the disk is completely dehydrated (black disk), this principle cannot be applied. Totally extruded hernia is also a contraindication.

PERCUTANEOUS DISCECTOMY BENEFITS WITH DISKOM:

  • Annular integrity preservation
  • Total procedure time: 10 to 15 minutes
  • Up to 2cc of disc material removed
  • Suitable for bioptic procedure
  • Available for thoraco-lumbar and cervical spine
  • Totally single use device
  • No further equipment needed
  • No capital investment required
  • No thermal damages to the nerve roots
  • Percutaneous access → totally MIS procedure
  • Fast recovery after treatment
  • Just local anesthesia needed
  • Fast discharge of the patient

PATIENT SELECTION

  • Radicular pain
  • MRI consistent with contained disc herniation
  • MRI demonstrating 50% preserved disc height
  • Failed conservative treatment
  • Facet pain excluded
  • Positive low-volume diagnostic selective nerve root block
  • Discogram and post-disco CT consistent with the above (optional)

SURGICAL PROCEDURE:

  1. Introduce the access needle through fluoroscopic guidance into the disc. Contrast liquid might be injected through the cannula.
  2. Remove the stylet and introduce the probe into the cannula, then connect the collection chamber to the access needle cannula, through the luer lock connection.
  3. Switch on the probe.
  4. Perform a backward and frontward movement , for 2/3 minutes combining it with a rotational movement
  5. Nucleus is removed and collected in the collection chamber or along the probe stylet
  6. Remove the device.
disc material collected from the nucleous polpous

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