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Related Concept Videos

Herniated Intervertebral Disc l: Introduction01:29

Herniated Intervertebral Disc l: Introduction

Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...
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The symptoms of degenerative disc disease arise from a combination of mechanical compression, vascular compromise, and biochemical inflammation, which together disrupt nerve function and produce pain.Mechanical CompressionDisc degeneration reduces height and elasticity, predisposing to herniation of the nucleus pulposus, a major cause of radicular pain. Herniations may be protrusion (bulging with intact annulus), extrusion (nucleus extends beyond disc but remains connected), or sequestration...
Degenerative Disc Disease I: Introduction01:27

Degenerative Disc Disease I: Introduction

Degenerative disc disease is a chronic condition in which intervertebral discs gradually lose structure and function. It is not infectious or autoimmune; rather, it results from age-related biochemical and mechanical changes, influenced by genetic, metabolic, and environmental factors.Structure and Function of DiscsThe spine contains 23 intervertebral discs that absorb load, distribute forces, maintain spacing, and allow flexibility. Each disc consists of a nucleus pulposus, a gel-like core...

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A Suture Technique for Ruptured Annulus Fibrosus Following Decompression Under Percutaneous Transforaminal Endoscopic Discectomy
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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

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|November 11, 2009
PubMed
Summary
This summary is machine-generated.

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.

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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.