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Published on: January 26, 2024
Plasma disc decompression for contained cervical disc herniation: a randomized, controlled trial
Alessandro Cesaroni1, Pier Vittorio Nardi
1Policlinico Casilino, U.O.C. Neurochirurgica, Via Casilina, 1049-00169 Rome, Italy. acesaro@tin.it
Summary
Plasma disc decompression (PDD) offers superior relief for contained cervical disc herniations compared to conservative care (CC). PDD patients experienced sustained pain reduction and functional improvement over one year, while CC patients showed signs of relapse.
Area of Science:
- Neurosurgery
- Minimally Invasive Spine Procedures
Background:
- Contained cervical disc herniations cause significant neck and arm pain.
- Previous studies indicated plasma disc decompression (PDD) is effective for nucleus decompression.
- Conservative care (CC) is a common initial treatment for such conditions.
Purpose of the Study:
- To compare the clinical outcomes of percutaneous PDD versus CC for contained cervical disc herniations over one year.
- To evaluate the efficacy of PDD in reducing pain and improving function.
- To assess long-term results and potential for relapse with CC.
Main Methods:
- A prospective, randomized controlled trial involving 115 patients with neck/arm pain.
- Patients were randomly assigned to PDD (n=62) or CC (n=58) after failing at least 30 days of CC.
- Outcomes measured using Visual Analog Scale (VAS) pain scores, Neck Disability Index (NDI), and SF-36 health survey at multiple follow-up points up to 1 year.
Main Results:
- PDD group showed significantly lower VAS pain scores at all follow-up points (P < 0.0001).
- PDD patients demonstrated significant NDI score improvement compared to CC at 6 weeks and 1 year (P < 0.0001 and P = 0.005, respectively).
- SF-36 physical component summary scores improved significantly more in the PDD group at 6 weeks and 1 year (P = 0.0004 and P = 0.0003, respectively).
Conclusions:
- Percutaneous PDD is associated with significantly better clinical outcomes than CC for contained cervical disc herniations.
- PDD provides sustained improvement, whereas CC patients experienced a relapse of symptoms at one year.
- PDD represents an effective treatment option for selected patients with cervical disc herniation.
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