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A Suture Technique for Ruptured Annulus Fibrosus Following Decompression Under Percutaneous Transforaminal Endoscopic Discectomy
Published on: January 26, 2024
Intradiscal therapies for discogenic pain
Stuart R Pomerantz1, Joshua A Hirsch
1Department of Neuroradiology, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
Seminars in Musculoskeletal Radiology
|April 6, 2006
Summary
Percutaneous intradiscal therapies, including percutaneous discectomy and annuloplasty, offer promising treatments for discogenic back pain. These minimally invasive procedures aim to decompress the disc and treat annular tears, providing relief for specific patient groups.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Pain Management
Background:
- Discogenic back pain, often caused by contained disc herniations or internal disc derangement (IDD), affects many individuals.
- Percutaneous intradiscal therapies have evolved since 1963, offering minimally invasive treatment options.
- Current technologies include percutaneous discectomy (e.g., DISC Nucleoplasty, Dekompressor) and annuloplasty (e.g., IntraDiscal Electrothermal Therapy, discTRODE).
Purpose of the Study:
- To review the history and current status of percutaneous intradiscal therapies for discogenic pain.
- To discuss the mechanisms and efficacy of percutaneous discectomy and annuloplasty.
- To highlight emerging intradiscal therapies for future evaluation.
Main Methods:
- Review of historical data and clinical outcomes of percutaneous intradiscal therapies.
- Description of percutaneous discectomy techniques for central disc decompression.
- Explanation of annuloplasty techniques for thermal treatment of internal disc derangement.
Main Results:
- Percutaneous discectomy achieves central decompression by removing nuclear tissue, reducing disc pressure and relieving neural compression.
- Annuloplasty techniques show potential effectiveness for degenerative disc disease with painful annular fissures.
- A 40-year history supports the concept of percutaneous disc decompression, with promising initial results.
Conclusions:
- Percutaneous intradiscal therapies represent a significant advancement in treating discogenic back and leg pain.
- These minimally invasive procedures offer effective solutions for appropriately selected patients.
- Ongoing research and emerging therapies continue to expand the percutaneous treatment landscape for discogenic pain.
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