Interventions on the intervertebral discs : Indications, techniques and evidence levels.

[Interventions on the intervertebral discs : Indications, techniques and evidence levels]. Radiologe. 2015 Sep 2; Authors: Streitparth F, Disch AC Abstract CLINICAL ISSUE: Over the last decades a number of different minimally invasive interventions have been proposed for the treatment of intervertebral disc herniation and degeneration. All of these interventions aim at relieving pressure from compressed nerve roots by mechanical ablation, chemical dissolution, evaporation or coagulation of disc tissue. STANDARD TREATMENT: Microsurgical sequestrectomy with direct visualization of the spinal canal. TREATMENT INNOVATIONS: Minimally invasive intradiscal interventions, such as chemonucleolysis, manual and automated disc decompression, laser disc decompression, nucleoplasty and thermal anular radiofrequency (RF) techniques with posterolateral access to the intervertebral disc. PERFORMANCE: The effectiveness and safety of the different minimally invasive procedures are compared to the standard surgical procedure on the basis of a literature review. ACHIEVEMENTS: For patients with disc herniation requiring surgery, microsurgical sequestrectomy is the treatment of choice, while discectomy is obsolete. Intradiscal procedures have a low level of evidence while long-term results are still lacking. Randomized controlled trials are required to generate evidence-based results. PRACTICAL RECOMMENDATIONS: Indications for treatment should be estab...
Source: Der Radiologe - Category: Radiology Authors: Tags: Radiologe Source Type: research

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