Minimally invasive techniques for cervical discogenic pain

  With regard to clinical symptoms caused by cervical disc degeneration, bulging and herniation, we have summarized our years of experience and found that decompression and removal of foreign nerves are the two main advantages and features of our minimally invasive treatment.  In terms of decompression, we have used general radiofrequency thermal coagulation decompression and found that it often has the disadvantage of insufficient decompression, but 80 degree thermal coagulation is effective in destroying the nerve fibers in the lesioned annulus fibrosus, and we still retain this method for the treatment of cervical discogenic pain without radicular symptoms. Later, laser decompression was used to treat patients with large cervical disc herniations, and the decompression effect was immediately apparent. After using it for a long time, we found that it also had the problem of local edema for a longer period of time due to thermal injury. In response we studied the effect of bipolar radiofrequency, which we still apply today because of the greater volume of thermal coagulation at the same temperature and a clearly controllable range.  But the bigger protruding cervical disc problem, we still leave it to the surgeon to treat surgically. After the publication a year ago of the good results of the treatment of larger herniated cervical discs with a specially designed plasma tip for the cervical spine by the leading scholars in China, we have followed this pace actively and cautiously. More promising results have been achieved. Medical experts and medical device scientists have worked diligently to design no less than ten new technologies to address herniated discs, which will bring benefits to more patients based on the right indications.  The mechanism of action of plasma is (plasma) to make the nucleus pulposus cells cleaved into simple carbohydrates and oxides (vaporized material), and the nucleus pulposus ablated, and can make the nucleus pulposus in the collagen molecular helix structure linkage change, so that the protein volume becomes smaller, to achieve the treatment purpose of reducing the internal pressure, the herniated part back.  Its advantage is that the working temperature is 40-70 degrees, which is much lower and safer than the standard radiofrequency temperature of 80-90 degrees, and it can protect the wall of the annulus fibrosus to the maximum extent for the cervical disc; remove the tissue more effectively; have a small impact on the stability of the spine, and the rate of re-protrusion of the disc is low; and interfere with the nerve roots is small. Short hospitalization time.  However, for headache, neck pain, shoulder pain and scapular region pain of cervical disc origin without obvious protrusion, we still think that the cheaper bipolar radiofrequency and the general radiofrequency with special needle are more effective.