Radiofrequency: application in lumbar ddd with the “3 in 1” technique

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S. Hellinger Dr.med.
Orthopädie Schäfflerhof / ISAR Klinik München

Address:
München
Germany

Citation: S. Hellinger : Radiofrequency: application in lumbar ddd with the “3 in 1” technique . The Internet Journal of Minimally Invasive Spinal Technology. 2008 Supplement I - to IJMIST Vol 1 No 2

Abstract

In cooperation with Arnold E. Feldmann, First Choice Surgery Center Baton Rouge, USA Chemonucleolysis and percutaneous discectomy as well as laser decompression and discectomy are used methods besides the rapidely developing endoscopic techniques as minimal aggressive techniques for discal pain syndromes. In recent years, the use of high radiofrequency energy was added to this spectrum. Every technique from hermocoagulation for annuloplasty to the “coblation” must be considered as unique procedure. A new minimally invasive technology for the treatement of discal diseases of the lumbar spine with high radiofrequency based on the extensive use of the percutaneous RF-techniques and and positive experiences with use in endoscopic spine surgery has been developed to recombine the advantages of the different methods in one minimal invasive surgery. The purpose of the presentation is to assess the potential of this highradiofrequency based combination procedure. First we will discuss basic investigations for the efficiency and safety for this procedure. Then we will present our clinical results demonstrating the surgical technique with the special assessable probe in a controlled prospective study. Methods: For this first prospective outcome study 66 patients with radicular pain syndromes and simple neurological deficits as well as contained disc extrusions or protrusions has been included. We did the procedures in two different centers by different surgeons in different cultures and investigated the outcome postoperatively, after 6 weeks and 6 months by a standardized protocol partly by independent investigators. Beside the clinical results two scores has been observed. Results:The VAS is demonstrating an improvement from 8,6 to 1.9 two days postoperative, 3,5 after 6weeks and 3,3 after 6 Months. The SLRT and the neurological deficits improved significantly. The McNab index is showing on av. an excellent outcome postoperativly and a good after six weeks and six months, as well as the Andrews and Lavyene Score. Until now there has been no complications. The first results encourage us to include this procedure in ouer spectrum of minimal invasive spine surgery be comparable to the other minimal invasive procedures avoiding an open surgery and to fill the gap in the cascade of treatment of discal disorders. The combination of different techniques in one procedure mark an advantage and seems to be superior to a single technique. Cause of the smaller instruments it is less invasive than an fullendoscopic procedure by the marked indications, but an endoscopic assisted controll is possible.

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