Interventional spinal procedures

Cosma Andreula, Mario Muto, Marco Leonardi

Research output: Contribution to journalArticlepeer-review

Abstract

The interventional procedures for disk herniation and protrusion by percutaneous techniques are decompressive such as chemodiscolysis with chimopapain, nucleo-discectomy introduced by Onik, LASER discectomy, and recently nucleoplasty, and decompressive and direct antinflammatory such as chemiodiscolysis with an Oxygen-ozone mixture. These techniques have minimized the invasive nature of surgery and avoid or decrease complications like infection linked to surgery. Reducing intervertebral disc size by mechanical aspiration of a part of the disc or partially dissolving the herniation by drying reduces the conic pressure on the torn annulus and creates the space necessary for retropulsion whenever the circular fibres of the annulus regain a minimum capacity to contain the disc under tension. The proposed suggestion in these techniques is that a small change in volume produces large change in pressure. The success rates reported in different studies vary from 65 to 80% of excellent or good results with chemonucleolysis and aspiration. Vertebroplasty (VP) is done by percutaneous injection of acrylic cement (polymethylmetacrylate-PMMA) into the vertebrae under fluoroscopic and/or CT control to achieve an antalgic effect and stabilize the vertebral body. VP has been used for vertebral collapses caused by osteoporosis, long-term steroid treatment, aggressive symptomatic angiomas and lytic metastasis. The reported figures in literature are 80-95% of pain relief, within 7 days after procedure, commonly on the same day.

Original languageEnglish
Pages (from-to)112-119
Number of pages8
JournalEuropean Journal of Radiology
Volume50
Issue number2
DOIs
Publication statusPublished - May 2004

Keywords

  • Chemiodiscolys with oxygen-ozone mixture
  • Kyphoplasty
  • Nucleoplasty
  • Percutaneous discolysis
  • Vertebroplasty

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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