I. Introduction of low-temperature plasma
In the 1990s, radiofrequency vaporization was widely used in cosmetic surgery and joint surgery, and in 1999, the U.S. FDA formally approved its application in minimally invasive spine surgery. In September 2002, the first cervical radiofrequency ablation myeloplasty was performed in the United States and was successful. Plasma disc ablation is a safe, minimally invasive treatment for cervical and lumbar disc herniation. It is a minimally invasive cryoablation and precise thermal wrinkling technique that allows for precise and controlled nucleoplasty and disc decompression.
The principle of low-temperature plasma is: applying plasma ablation technology, combining thermal coagulation and ablation to remove part of the nucleus pulposus, using low-temperature plasma ablation technology to vaporize part of the nucleus pulposus tissue in real time to achieve the purpose of reducing the volume of the nucleus pulposus; then using precise thermal wrinkling technology to heat up the nucleus pulposus tissue contacted by the blade to about 70°C, so that the total volume of the nucleus pulposus is reduced, reducing the pressure in the disc to achieve decompression. to achieve decompression therapy. The plasma ablation technique (Coblation) applies radiofrequency energy to a conductive medium (usually saline) to form a highly convergent thin layer of low-temperature plasma around the electrode with excitation energy. The thin layer of plasma consists of highly ionized particles that have sufficient kinetic energy to break the peptide bonds of large molecules in the tissue, causing them to break down into low molecular weight molecules and atoms, and to be discharged from the body through the puncture channel, resulting in real-time, efficient and precise cutting and ablation effects.
Second, the advantages of plasma ablation and wrinkling
1.The thin layer of low-temperature plasma formed at the front of the cutter head can precisely ablate the pulpal tissue and has the incomparable advantages of other technologies with advanced science.
2, the plasma head are bipolar structure, the electric field will not penetrate deep into the patient’s body, with a very high safety factor, plasma ablation only produces a temperature of 53 ℃, the temperature 1 mm beyond the surface of the head is less than 43 ℃, the plasma knife can precisely control the temperature at 60-70 ℃, so that the collagen molecule spiral structure crinkled, to achieve the role of forming without affecting the cell activity. In the case of correct operation, there will be no thermal damage to other surrounding tissues.
3.With real-time ablation function, the decompression effect can be shown during the operation, and the postoperative effect can be seen immediately, with an efficiency of 97% and a satisfaction rate of 81%.
C. Indications for cervical low-temperature plasma
A back stiffness/soreness/pain/numbness;
B Dizziness/headache/numbness of head and face;
C pulsating and swelling pain of the top temporal vessels;
D transient blackness;
E eye dryness/distension/decreased visual acuity;
F nasal blockage sensation;
G tinnitus/with hearing loss;
H Heartburn/palpitations/shortness of breath;
I nausea and vomiting;
J Sternal (anterior) pain/pressure;
K upper extremity soreness/pain/numbness/weakness and other discomfort;
L upper extremity / lower extremity coldness;
M lower extremity weakness/unsteady walking/acidity and numbness, etc;
N memory loss;
O refractory hypertension;
P Decreased quality of sleep (dreaming and waking up easily, etc.);
Q feeling of chest and abdominal straps / walking on cotton;
R waist and hip soreness / pain and discomfort.
IV. Perioperative management of percutaneous minimally invasive low-temperature plasma
Preoperative improvement of cervical spine MRI, cervical spine front and side, power position film examination, as well as electrocardiogram, whole chest film, coagulation picture, blood and urine and other routine examination can be. The operation is performed under local anesthesia, and there is no need to fast before the operation, and you can eat and drink and move freely after the operation. If there are no special circumstances, you can be discharged from the hospital the day after surgery to recuperate, and the hospital stay will be 2-3 days.
V. Postoperative prevention and health care
Wear a neck brace for 2-3 weeks after surgery. Some patients’ symptoms may fluctuate during this period, so there is no need to be anxious. Sleep with a low pillow and a slightly elevated pillow when lying on your side, and a duck down pillow is recommended to keep the neck muscles relaxed. Do not work with your head down for too long, rest for 5-10 minutes every 40-50 minutes, and do the “rice” health exercise.