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[How much intervertebral disk tissue is in reality removed in percutaneous nucleotomy?]
W H Castro1, J Jerosch, H Halm
1Klinik und Poliklinik für Allgemeine Orthopädie, Westfälischen Wilhelms-Universität Münster.
Zeitschrift Fur Orthopadie Und Ihre Grenzgebiete
|November 1, 1992
Summary
Comparing lumbar disc surgery methods requires careful consideration of tissue weight. Wet weights are unreliable due to differing saline absorption between non-automated (NAPLD) and automated (APLD) discectomy methods.
Area of Science:
- Spine Surgery
- Biomaterials Science
- Surgical Techniques
Background:
- Accurate quantification of excised tissue is crucial for understanding biomechanical changes after discectomy.
- Standardized comparison of surgical techniques like non-automated (NAPLD) and automated (APLD) discectomy is challenging due to methodological differences.
- Previous studies may not have accounted for variations in fluid absorption by excised disc material.
Purpose of the Study:
- To investigate the impact of saline absorption on the weight of excised nuclear material using two discectomy methods.
- To determine if wet weight measurements are comparable between the non-automated discectomy method (NAPLD) and the automated discectomy method (APLD).
- To establish a reliable method for comparing the amount of tissue removed in clinical studies involving discectomy.
Main Methods:
- Excised nuclear material from 40 human lumbar discs was obtained under standardized conditions.
- Twenty samples were processed using the non-automated discectomy method (NAPLD), and twenty using the automated discectomy method (APLD).
- Excised material was weighed, then subjected to saline immersion and re-weighing, followed by freeze-drying and final weighing.
Main Results:
- The wet weight of NAPLD material showed a 11-fold difference compared to its freeze-dried weight (7.7g vs 0.7g).
- The wet weight of APLD material showed a 15-fold difference compared to its freeze-dried weight (4.5g vs 0.3g).
- Significant differences in saline uptake and distribution were observed between the NAPLD and APLD methods, rendering direct wet weight comparison invalid.
Conclusions:
- Direct comparison of wet weights between NAPLD and APLD discectomy methods is not permissible due to differential saline absorption.
- Future clinical comparative studies must consider freeze-dried weight for accurate quantification of excised nuclear material.
- Standardized comparison of discectomy techniques necessitates accounting for the amount of excised material, preferably measured by freeze-dried weight.