Percutaneous plasma laser disc coagulation and navigable ablation decompression in the treatment of cervical disc herniation: a single center experience

Abstract

Background/aim: We aimed to compare the effectivity of percutaneous disc coagulation therapy (PDCT) and navigable ablation decompression treatment (L-DISQ) in patients who were diagnosed with cervical disc herniation.

Materials and methods: Visual analog scale (VAS) and Neck Pain Index (NPI) scores were recorded initially and at the 1st, 3rd, 6th, and 12th months after the procedures. Patient Satisfaction Scale (PSS) scores were recorded 12 months after the procedures

Results: Mean VAS scores were 7.55 and 3.1 points in the PDCT group and 7.6 and 3.00 points in the L-DISQ group; mean NPI scores were 34.2 and 20.75 points in the PDCT group and and 34.1 and 20.4 points in the L-DISQ group initially and at the 12th month. When compared between months, there was a significant decrease in time-dependent VAS and NPI scores in both PDCT and L-DISQ groups (P = 0.001). Some complications included esophageal, vascular, and neural injuries; hoarseness; Horner syndrome; infections; dural puncture; and muscle spasm. The only difference between groups was the rate of cervical spasm within 1 month after the procedure: 75% in the PDCT group and 15% in the L-DISQ group.

Conclusion: The diameter of the canal of the cervical vertebrae is narrower than of the lumbar and thoracic regions; therefore, the smaller part of the disc may be sufficient to create clinical signs. The response to decompression therapies is faster in the case of cervical percutaneous procedures that are performed correctly. Proper patient selection and practitioner’s experience are important in the treatment success

Keywords: Navigable ablation; intradiscal decompression; percutaneous disc coagulation therapy; cervical herniation.

Figure 1

Although PDCT is used to reduce the problems associated with other laser applications, its probe cannot be seen in the disc through fluoroscopy.