What is radiofrequency ablation myeloplasty?

  Discogenic lower back pain and disc herniation, which are extremely common clinical conditions, are receiving increasing attention. With the increasing awareness of discogenic pain, many treatment methods have been generated, including non-surgical, minimally invasive surgery and open surgery. Minimally invasive surgery has the advantages of being less invasive, highly operable, and with fewer complications, and is gradually becoming more widely used. Among them, radiofrequency ablation myeloplasty is one of the methods that are currently used more often.  Radiofrequency ablation myeloplasty is commonly used to treat cervical and lumbar discogenic pain and disc herniation, which combines the percutaneous puncture technique of spinal surgery with the cold ablation technique based on radiofrequency energy. The nucleus pulposus is remodeled and closed with 70℃ thermal coagulation, causing the collagen fibers in the nucleus pulposus to vaporize, contract and solidify, reducing the total volume of the disc, thereby reducing the pressure in the disc and achieving the treatment purpose.  Low-temperature plasma ablation, or “cold ablation” technology, uses radiofrequency electric field to generate a thin layer of plasma, so that the ions gain enough kinetic energy to break the molecular bonds to form a cutting and ablative effect, so that the large molecules decompose into single-element molecules and low-molecular gases, which replace the excised tissue and are discharged through the channel, thereby achieving decompression. The cold ablation process is a low temperature state in which the molecular chains of cells are broken and the function is cutting, tightening, hemostasis and welding. When the energy set is below the threshold for plasma generation, the electrical resistance of the tissue causes a thermal effect that causes the tissue to contract or act as a hemostat. Few clinical complications have been reported with this method for the treatment of disc herniation. The main ones are pain at the puncture site, or new areas of pain, which usually resolve on their own, and some less common complications.  Radiofrequency ablation myeloplasty requires strict selection of surgical indications to achieve better results. In addition, it has a certain recurrence rate due to limited removal of degenerated disc tissue, but it is less invasive, basically no bleeding, mild pain, short operative time, and can be performed on the same day after surgery with a neck brace or lumbar girth, with good recent results; low local temperature, no damage to surrounding tissues; and also has no easy damage to nerve roots and dura. It also has the advantages of not easily damaging the nerve roots and dura mater, and the chance of intervertebral infection is small.  Radiofrequency ablation myeloplasty indications: discogenic low back pain, inclusive disc herniation (cervical, lumbar), cervicogenic dizziness.  Contraindications to radiofrequency ablation myeloplasty: non-inclusive disc herniation, spinal instability, medullary cervical spondylosis, spinal stenosis.