Coblation Nucleoplasty–Minimally invasive treatment of cervical spondylosis and lumbar discogenic low back pain (1) Overview 1. Minimally invasive, safe and efficient clinical treatment means. 2. 2, the role of the site: the nucleus pulposus 3, the operating temperature: <70 ℃ 4, the mechanism: low-temperature plasma ablation is through the conductive medium (salt) formed around the electrode in the plasma area of the highly ionized particles (Figure 1) to crush the organic molecules within the tissue of the molecular chain, so that the molecules and molecules are separated (Figure 2), the ablation of the fixed-point thermal coagulation, so that the disc within the main components - elastic fibers spiral structure The main component of the intervertebral disc, the elastic fiber helical structure, shrinks again, thus reducing the volume of the intervertebral disc tissue. Since the electric current does not flow directly through the tissue, the tissue heats up very little. The data shows that the surface tissue temperature is maintained at 40-70℃. Both to ensure that the collagen molecular spiral structure wrinkled, but also to maintain the vitality of the cells, coupled with a small heat penetration, so both direct and indirect tissue damage is very small. Low-temperature plasma surgical system has been widely used in domestic and foreign fields in recent years, and the clinical effect is also very good. The use of plasma vaporization, crumpling of the medulla oblongata reduces the pressure within the intervertebral disc, effectively relieving the protruding medulla oblongata from the purpose of compression of the surrounding tissues of the intervertebral disc (nerve roots, arteries, spinal cord, etc.), eliminating and relieving the clinical symptoms, and at the same time, maximizing the protection of the annulus fibrosus. 5.Surgical puncture technique is simple: the same as discography, completed under local anesthesia, the surgical wound is less than 1mm, the operation time is short, each disc segment operation time is about 5 minutes. 6.Application scope: cervical and lumbar intervertebral disc herniation (bulging) cases, cervical spondylosis is especially effective, immediate results. Figure 1 Figure 2 Figure 3 I. Cervical spine adapted to the crowd: 1, shoulder and neck heaviness, pain accompanied by upper extremity radicular soreness, burning pain and other symptoms confirmed by MRI corresponding interspace disc herniation of cervical spondylosis patients. 2.Accompanied by persistent headache, dizziness, tinnitus, vertigo, insomnia and have ruled out internal medicine-related diseases, caused by cervical spondylosis, dizziness, nausea, numbness of the limbs and fatigue, neck and shoulder pain. 3, at present my department to expand the treatment of spinal cord cervical spondylosis, the effect is good, including severe disc herniation of patients, including the end of the operation, including lower extremity symptoms get immediate relief, some patients combined with monocular blurring of vision is also improved, part of the patients after the operation of the facial blood flow to improve the face, facial hyperpigmentation (spots), follow up review of the hands of Hoffmann's pathology signs turn negative. Second, lumbar spine adapted to the population: 1, sedentary or standing for a long time to appear lumbar pain accompanied by hip or lower extremity radiating/shooting pain (nerve root irritation related to intervertebral disc pressure as the main symptom). 2, Positive discography, disc height ≥75%; 3, MRI diagnosis of inclusive disc herniation, unilateral disc bulge/herniation with nerve root contact has the best results. 4. Those who have recurrence after surgical treatment. Clinical advantages: simple operation, safety, minimally invasive, good efficacy, fast recovery, under local anesthesia. Conclusion: For many patients with intervertebral discogenic pain, plasma radiofrequency ablation myeloplasty can effectively relieve the symptoms of nerve compression, prevent the tendency of aggravation, significantly reduce the possibility of open surgery in the future, and improve the patient's quality of life by using plasma radiofrequency ablation myeloplasty in a timely manner for treatment of patients with intervertebral discogenic pain before the annulus fibrosus is ruptured. Nucleus removal). Since the treatment method is simple, safe, minimally invasive, minimally damaging, and highly effective, it has been highly valued by professionals at home and abroad. Since its clinical application in 2001, more than tens of thousands of patients around the world have been treated with this method every year without complications, and have been free from the pain of open surgeries, which has been regarded as the safest and most reliable minimally invasive surgery for treating the intervertebral discs nowadays. Comparison between percutaneous plasma Nucleoplasty and other treatment methods (a), comparison with percutaneous aspiration percutaneous plasma Nucleoplasty Nucleus pulposus cutting and suctioning puncture orifice is small (1.0 mm) puncture orifice is more than 3.0 mm, the efficacy of the exact efficacy of the inaccurate damage, slight damage, damage to the larger does not destroy the annulus fibrosus, the annulus fibrosus damage is large, the postoperative period does not have to be bedridden after the operation, you need to be bedridden after the operation for one week, the puncture orifice is not blood seepage puncture orifice often have blood (the orifice often have blood). (b) Comparison with laser treatment (PLDD) Percutaneous plasma myeloplasty Laser treatment (PLDD) Local temperature is low (40-70 degrees) Local temperature is high (300-600 degrees) Injury is mild Injury is high Pain is low Pain is high Pain is low Pain is high Pain is low Pain is low No need to be bedridden Cannot be active at early stage after operation. Plasma myeloplasty Collagenase treatment No obvious pain during and after surgery Strong postoperative pain reaction No obvious complications Easy to damage nerve roots and dura mater No allergic reaction An allergic reaction occurs No effect product remains Yes effect product remains Cervical spondylosis case introduction: