• Plos One · Jan 2012

    Disc volume reduction with percutaneous nucleoplasty in an animal model.

    • Richard Kasch, Birger Mensel, Florian Schmidt, Sebastian Ruetten, Thomas Barz, Susanne Froehlich, Rebecca Seipel, Harry R Merk, and Ralph Kayser.
    • Clinic and Outpatient Clinic for Orthopedics and Orthopedic Surgery, Greifswald University Medicine, Greifswald, Germany. richard.kasch@uni-greifswald.de
    • Plos One. 2012 Jan 1; 7 (11): e50211.

    Study DesignWe assessed volume following nucleoplasty disc decompression in lower lumbar spines from cadaveric pigs using 7.1Tesla magnetic resonance imaging (MRI).PurposeTo investigate coblation-induced volume reductions as a possible mechanism underlying nucleoplasty.MethodsWe assessed volume following nucleoplastic disc decompression in pig spines using 7.1-Tesla MRI. Volumetry was performed in lumbar discs of 21 postmortem pigs. A preoperative image data set was obtained, volume was determined, and either disc decompression or placebo therapy was performed in a randomized manner. Group 1 (nucleoplasty group) was treated according to the usual nucleoplasty protocol with coblation current applied to 6 channels for 10 seconds each in an application field of 360°; in group 2 (placebo group) the same procedure was performed but without coblation current. After the procedure, a second data set was generated and volumes calculated and matched with the preoperative measurements in a blinded manner. To analyze the effectiveness of nucleoplasty, volumes between treatment and placebo groups were compared.ResultsThe average preoperative nucleus volume was 0.994 ml (SD: 0.298 ml). In the nucleoplasty group (n = 21) volume was reduced by an average of 0.087 ml (SD: 0.110 ml) or 7.14%. In the placebo group (n = 21) volume was increased by an average of 0.075 ml (SD: 0.075 ml) or 8.94%. The average nucleoplasty-induced volume reduction was 0.162 ml (SD: 0.124 ml) or 16.08%. Volume reduction in lumbar discs was significant in favor of the nucleoplasty group (p<0.0001).ConclusionsOur study demonstrates that nucleoplasty has a volume-reducing effect on the lumbar nucleus pulposus in an animal model. Furthermore, we show the volume reduction to be a coblation effect of nucleoplasty in porcine discs.

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