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Minimally Invasive Disc-FX Disc Procedure for Discogenic Pain

By : on : March 23, 2017 comments : (0)

What exactly is Disc Fix?

This procedure is just a pinhole technique, instead of giving a large incision in conventional spine surgery for disc related pain problem-disc protrusion or discogenic pain.Just tiny incision of 3mm enough-no need of blood transfusion-mean no blood loss.
briefly
  • Indication: Painful spinal disc protrusion or annular tear in disc.
  • Strategy: A small tube size of 3.1 mm is inserted into the affected disc.
  • Inpatient treatment: 1-2 days
  • Rehabilitation treatment: 14 days outpatient or inpatient rehabilitation
  • Earliest flight home: 2 days after procedure
  • Time before showering: 1 day after surgery
  • Recommended time off work: 28 days
  • Time before driving a car: 14 days

A diffuse bulge or protrusion of disc material {nucleus pulposus} can cause deep-rooted back pain or radiating pain reaching to leg. After exhausting all conservative treatment methods (physical therapy-exercises-physiotherapy and pain therapy), the Disc-FX technique is a minimally invasive nucleoplasty  technique for treating this dipsogenic pain, i.e. pain originated within the disc.

Terminology

  • Disc-FX technique: Combined procedure of endoscopic disc surgery of mechanical treatment with mini forceps and electrothermic treatment with localised generation of heat[radio-frequency waves]
  • Protruding disc: Bulging of the disc, can cause pressure on the nerve roots
  • Discogenic back pain: Back pain caused by disc material putting pressure on traversing or exiting nerve roots or thecae sac
  • Endoscopic disc surgery: Disc surgery with 3-4mm incision and sutures through a surgical cannula (hollow needle) with endoscopic view of the surgical site.
  • Percutaneous nucleotomy: Minimally invasive (endoscopic) treatment to mechanically remove material nucleus pulposus from a bulging disc.

Which surgical procedure can help with a bulging disc?Treating the bulging disc with the Disc-FX system. Bulging discs are caused by the liquid nucleus pulposus shifting inside the disc. The fibrous ring of the disc is deformed, but not yet ruptured.

The Disc-FX technique is a percutaneous endoscopic decompression as well as neuromodulation by radio frequency wave, That means the surgery is performed with 3-4 mm surgical incision. Merely a surgical cannula in inserted through the skin into the surgical site on the disc. The procedure is performed with a direct endoscopic view using a small camera inside the surgical cannula.

Live fluoroscopy monitors the position of the needle. Following the procedure, the surgical site can be closed with a plaster (no sutures).

Preventing scarring is one of the primary advantages of endoscopic disc fix surgery. Scarring after conventional open surgeries of the spine can result in long-term irritation of nerves and surrounding structure like facet joint, Disc-FX  procedurelamina, etc. causes defects in this area of the spine be known condition of failed back surgery syndrome.The scar-free endoscopy prevents this irritation of pain sensors. So compared to open micro-surgeries, the disc fix endoscopic spine procedure can be considered safer in comparison to conventional spine surgery..

In any case, your specialist must examine all concurrent circumstances of your back pain in detail through medical and imaging procedures befoDisc-FX procedure.

the technical aspect of disc fix procedure-

Disc-FX presents a new development in the area of minimally invasive spine surgeries. With a working access size of only 3-4 mm, Disc-FX provides the option to remove disc tissue within and outside the spinal canal (extra- and intraspinal), and to achieve therapeutic stabilization of the annulus.

The Disc-FX technique combines 2 minimally invasive disc and spine procedures:

  1. A thermal(radiofreuency ablation) procedure to reduce the volume by evaporating disc tissue (ablation) and annulus itself
  2. Removal of protruding or prolapsed disc tissues using surgical micro-forceps -(nucleotomy-debulking)

Advantages of disc endoscopy

  • Minimally invasive without scarring in the soft tissue area.
  • Easy healing of the wound-no surgical dressing require.
  • No surgical sutures, no taking stitches out.
  • No or little surgical pain following the procedure.
  • No extended stay hospitalization required.
  • Local anaesthesia is an option.along with sedation if required
  • Several discs can be treated in one session.
  • just an ambulatory procedure.resume activities as the early comparison to conventional surgery

Performing the Disc-FX disc surgery

Disc-FX is performed under fluoroscopy assisted by endoscopy. So the spine specialist operates with a direct view of the disc as the cause for the pain.

What exactly happens during the endoscopic disc surgery using the Disc-FX technique?

  • Small parts of the gelatinous disc core (nucleus pulposus) are evaporated using high-frequency current-radiofrequency.
  • The protruding disc shrinks, restoring its normal shape.
  • The protruding fibrous ring annulus of the diseased disc can withdraw due to the reduction in volume, thus pressure.
  • Decrease Pressure inside the disc made easy the nerve root.
  • Back pain and pain radiating into the leg (sciatic pain) decreases after the procedure and likely to disappears afterward.

When will the Disc-FX provide relief for disc protrusion?

As soon as procedure performed patient experience a good pain relief in affected area,without any red flag sign-like bowl-bladder-or motor power loss as may be part of any spine surgery.pain score is improved just after procedure.

Reducing the fibrous disc ring with Disc-FX

In addition to shrinking the gelatinous core of the disc, the flexible probe of the Disc-FX system, however, also allows for targeted treatment of the fibrous ring-annulus.. by means of neuromodulation as well as thermal ablation of sinuvertebral nerves.

The thermal procedure of the Disc-FX technique thickens the disc’s fibrous ring (annulus) at the diseased protrusion (thermal coagulation). This reduces the protrusion. Reducing the protrusion relieves the nerve root (decompression). Discogenic back pain and pain radiating into the legs is reduced. The thermal procedure can also reduce pain fibres which have migrated into the disc walls, achieving analgesia for discogenic back pain.

The process of an endoscopic Disc-FX procedure.

1. Anaesthesia and positioning

Patients are typically placed in prone position. The procedure is mostly performed under local anaesthetic monitored by an anaesthesiologist or physician.with all necessary safety measure as a standard protocol followed in any surgery.

2. Endoscopic Disc-FX surgery

After identifying the affected disc levels on fluoroscopy or CT, the guide probe (endoscopic access) is introduced into the diseased disc can be confirmed by discography  with contrast omnipaq with indigo carmine with a needle under local anaesthesia. The cannula is then inserted as the endoscopic working access to the diseased disc. After reviewing the position of the endoscopic working cannula,  by live fluoroscopy primarily the inner of the disc is then shrunk, followed by shrinking (thermal coagulation) of the annulus. Due to the generation of heat being localised by the thermal procedure, the pain fibres of the disc annulus are also removed as a desirable side effect. Even pain caused by the diseased disc is therefore abolished (discogenic pain).
This endoscopic disc surgery can generally flexibly expand the endoscopic disc surgery by another treatment step without additional surgical access: Instruments can be inserted using the same access, if necessary. The nerve root can be assessed with a direct view through the endoscope.

Chances of success and risks of endoscopic Disc-FX disc surgery

The success rate of Disc-FX is excellent with over 80% of patients satisfied with the procedure. However, this process too can only yield success after strict pre-procedure assessment of indication.prognosis is entirely depend on your clinical

There essentially is no surgery without risks: However, surgery-specific risks, e.g. damage to the nerve, can be minimised since the patient is only given twilight anaesthesia. This allows the surgeon and patient to communicate at procedure

You can Watch video of this Procedure in Video Velow

 

sanjay sharma

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