Circumferential measurement of anulus deviation after laser nucleotomy

Kutschera, H.-J.; Buchelt, Martin; Lack, Werner; Beer, Rudolf

doi:10.1002/(sici)1096-9101(1997)20:1<77::aid-lsm12>3.0.co;2-6

Cited by 5 publications

(7 citation statements)

References 14 publications

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“…82,97 The volume removed (478.5 ± 129.4 mm 3 ) and disc height loss (0.74 ± 0.3 mm) seen in the rongeurs group in this study were toward the higher end of the values reported by Zengerle et al 32 (150-300 mm 3 and 0.3-0.7 mm) although their measurements were made with 100 N of compression on the specimen, rather than the 50 N used here. The range of the disc height reduction seen in the post-laser group in this study, 0.2 ± 0.1 mm was similar to that reported by Kutschera et al 98 in the unloaded state (0.1-0.32 mm).…”

Section: Stiffnesssupporting

confidence: 90%

An in vitro comparison of three nucleus pulposus removal techniques for partial intervertebral disc replacement: An ultra‐high resolution MRI study

et al. 2022

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Background Nuclectomy, also known as nucleotomy, is a percutaneous surgical procedure performed to remove nucleus material from the center of the disc. Multiple techniques have been considered to perform a nuclectomy, however, the advantages and disadvantages of each are not well understood. Aims This in vitro biomechanical investigation on human cadaveric specimens aimed to quantitatively compare three nuclectomy techniques performed using an automated shaver, rongeurs, and laser. Material & Methods Comparisons were made in terms of mass, volume and location of material removal, changes in disc height, and stiffness. Fifteen vertebra–disc–vertebra lumbar specimens were acquired from six donors (40 ± 13 years) and split into three groups. Before and after nucleotomy axial mechanical tests were performed and T2‐weighted 9.4T MRIs were acquired for each specimen. Results When using the automated shaver and rongeurs similar volumes of disc material were removed (2.51 ± 1.10% and 2.76 ± 1.39% of the total disc volume, respectively), while considerably less material was removed using the laser (0.12 ± 0.07%). Nuclectomy using the automated shaver and rongeurs significantly reduced the toe‐region stiffness (p = 0.036), while the reduction in the linear region stiffness was significant only for the rongeurs group (p = 0.011). Post‐nuclectomy, 60% of the rongeurs group specimens showed changes in the endplate profile while 40% from the laser group showed subchondral marrow changes. Discussion From the MRIs, homogeneous cavities were seen in the center of the disc when using the automated shaver. When using rongeurs, material was removed non‐homogeneously both from the nucleus and annulus regions. Laser ablation formed small and localized cavities suggesting that the technique is not suitable to remove large volumes of material unless it is developed and optimized for this application. Conclusion The results demonstrate that both rongeurs and automated shavers can be used to remove large volumes of NP material but the reduced risk of collateral damage to surrounding tissues suggests that the automated shaver may be more suitable.

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Section: Stiffnesssupporting

confidence: 90%

An in vitro comparison of three nucleus pulposus removal techniques for partial intervertebral disc replacement: An ultra‐high resolution MRI study

et al. 2022

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“…After searching the medical literature and applying the inclusion criteria only 12 articles were located prior to the review. 2,4,6,7,9–16 The subsequent 12‐month literature search failed to locate any additional papers. None of the papers offered high‐quality evidence.…”

Section: Resultsmentioning

confidence: 99%

“…Evidence obtained from comparative studies with historical control, two or more single-arm studies or interrupted time series without a parallel control group IV Evidence obtained from case series, either post-test or pre-test and post-test prior to the review. 2,4,6,7,[9][10][11][12][13][14][15][16] The subsequent 12-month literature search failed to locate any additional papers. None of the papers offered high-quality evidence.…”

Section: Resultsmentioning

confidence: 99%

“…2,6 Seven articles could not be classified using the hierarchy of evidence table. 4,[11][12][13][14][15][16] Five of these were descriptions of the technique, 4,11,12,15,16 three of which repeated results described elsewhere 4,11,12 but with no additional results and insufficient detail to aid the review. Two papers described the effect of laser ablation on cadaveric tissue.…”

Section: Resultsmentioning

confidence: 99%

“…Two papers described the effect of laser ablation on cadaveric tissue. 13,14 The reported risks and benefits for the PELD procedure are shown in Table 2; the design and outcomes for the time and case series studies are shown in Table 3.…”

Section: Resultsmentioning

confidence: 99%

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