New technology for cervical spondylosis and lumbar disc herniation

Cervical spondylosis and lumbar disc herniation are common and frequent diseases in clinical spine surgery and can be clearly diagnosed after clinical examination and imaging by a spine surgeon. There are many ways to treat cervical spondylosis and lumbar disc herniation, and it is confusing for many patients to know which treatment they should receive. The following is the introduction of minimally invasive low-temperature plasma nucleus pulposus ablation, a new technology in the international treatment of cervical spondylosis and lumbar disc herniation. Our hospital is the only hospital in the Weifang area that carries out cryogenic plasma nucleus pulposus ablation, and has completed dozens of surgeries and achieved good clinical results. Cryogenic plasma nucleus pulposus ablation is a combination of tissue ablation and thermal coagulation, through the ablation and vaporization of the nucleus pulposus tissue of the intervertebral disc, thus reducing the pressure in the disc, and thus relieving the compression of the dura and nerve roots, and playing a role in relieving pain. The main principles are: 1. Cold ablation and cutting technology (40℃) 1mm diameter ablation needle punctures into the nucleus pulposus, firstly, in ablation mode, using 100Hz RF energy to act on the vaporization electrode, surrounding Na+ aggregation, movement, impacting and breaking the molecular chain of the nucleus pulposus tissue, decomposing the tissue to form elemental molecules and low molecular gases (O2, H2, CO2), the gas overflows through the puncture channel, and the nucleus pulposus tissue Reduction. 2.Thermal coagulation technique (70℃) The ablation needle adopts thermal coagulation mode to act on the nucleus pulposus tissue, which will vaporize, contract and solidify the collagen fibers and reduce the size of the nucleus pulposus. The plasma tip reaches the target tissue of the nucleus pulposus through the guidance of the puncture needle, which makes the nucleus pulposus achieve volume and pressure reduction, and the very small pressure reduction will obviously reduce the irritation of the lesion on the nerve root or nerve endings, thus relieving the symptoms. In addition, some of the intramedullary tissue is removed and the intradiscal nucleus pulposus is remodeled, while radiofrequency thermocoagulation causes collagen contraction of the disc nucleus pulposus to solidify. Compared with other types of decompression surgery, low-temperature plasma nucleus pulposus ablation is characterized by: 1, simple operation (puncture under local anesthesia guided by C-arm X-ray machine); 2, small trauma, the diameter of the puncture needle is only 1 mm, the puncture channel basically no blood leakage; 3, safe (the instrument only produces a temperature of 40 ℃ when working, and produces a temperature of about 70 ℃ when heating, the temperature range is 40 ℃ ~ 70 ℃, with Very small heat penetration and tissue necrosis, only on the surrounding 2mm range of tissue); 4, low temperature plasma nucleus pulposus ablation only interrupt the molecular structure of the tissue, only to change the biochemical state of the disc, rather than the direct thermal degeneration of the disc. In the study, it was found that myeloablation decompresses the nucleus pulposus but does not lead to necrosis, and the tissue vaporization and coagulation is only limited to the nucleus pulposus, while the annulus fibrosus, end plate and vertebral body are not affected, and myeloablation achieves volumetric removal of the intervertebral disc without significant thermal and structural damage to the surrounding tissues, and there are no postoperative complications such as spinal cord, nerve and vascular damage. There is no effect on the stability of the spine. Good indications for lumbar disc herniation are as follows: 1, low back and leg pain, with leg pain being the most important, and a positive straight leg raise test; 2, manifestations of nerve root injury, such as abnormal superficial sensation, decreased muscle strength, and abnormal reflexes; 3, herniated or limited bulging discs confirmed by CT or MRI, and clinical symptoms and signs consistent with the imaging diagnosis. 4.People who are afraid of open surgery. Good indications for cervical spondylosis are as follows: 1. cervical vertigo; 2. shoulder and neck pain and heaviness with obvious upper limb soreness, burning pain and numbness; 3. simple cervical disc herniation; 4. unilateral disc herniation confirmed by MRI after three months of conservative treatment with poor results; 5. unilateral type of neurogenic symptoms with cervical spine osteophytes and mild degeneration.