Feasibility of Navigable Percutaneous Disk Decompressor (L'DISQ-C) for Cervical Disk Herniation.

Abstract

To assess the procedural efficacy and safety of a Navigable Percutaneous Disk Decompressor (L'DISQ-C) for cervical disk herniation. We performed intradiskal decompression on cervical spine specimens from five human cadavers using the L'DISQ-C under C-arm fluoroscopic guidance. We evaluated our success for positioning the navigable wand tip into the target region and recorded temperature variation at various distances from the wand tip in the cervical nucleus pulposus. The histologic effect of plasma decompression was examined microscopically using harvested tissues adjacent to the procedure site. We successfully navigated the tip of the L'DISQ-C into the target region of the posterior cervical disks on the first insertion attempt in all C3-C4 to C6-C7 disks and in 50% of the C2-C3 and C7-T1 disks. The average temperature elevations within the nucleus pulposus ranged from 4.14 ± 0.08°C to 12.17 ± 0.76°C at various distances from the wand tip with or without saline infusion. A histologic examination showed only minor denaturation at the marginal border of the procedure tract. We effectively navigated the L'DISQ-C wand tip into the posterior target region of six cadaveric cervical disks and performed percutaneous resection of the target disk tissues without significant thermal or structural damage to adjacent tissues.