What is discoplasty with Discogel?
Discoplasty constitutes the most modern bloodless discopathy treatment method, either in the cervical or lumbar spine. It is a minimally invasive surgical technique.
This method includes the percutaneous infusion of a special gelatinous material (which consists of ethyl alcohol, cellulose and a radiopaque substance- Discogel) within the intervertebral degenerated disc. General anaesthesia is not required since the intervention is bloodless. Local anaesthesia is applied at the entry points of the special fine needles.
The substance is injected into the warn out disc under fluoroscopic monitoring with special equipment. This allows the surgeon to retain control throughout the operation.
How does Discogel act?
The drug injected into the centre of the disc causes an osmotic effect, gradually absorbing hernia liquids from the periphery to the centre of the nucleus. In this way a new disc nucleus is reconstructed, decompressing parallelly the hernia and consequently the pressure that it causes. Furthermore, Discogel seals any crack of disc integument (fibrous ring) occurring due to its degeneration. This results in the exit of inflammatory substances to nerve roots being inhibited. Because of this action, the correct medical term for this method is “Nucleolysis” since in essence it destructs nucleus pulposus of the intervertebral disc.
In which cases can Discogel be applied?
The technique of discoplasty can be used for the treatment of intervertebral disc hernia not only in the neck, but also in low back. One of its many comparative advantages is that it enables simultaneous treatment of not only one, but also two, three or more affected discs. An extra advantage of this method is that it can be combined with anaesthetic and cortisone infusion in vertebral joints, something that I usually do in my cases. In one session the patient is thus able to permanently confront a chronic problem which has an extremely negative effect on their personal and professional daily routine.
What are the success rates of operation with Discogel?
When the technique is applied within the framework of correct indications, success rates are over 75%. The extremely important advantage of this method is that it constitutes a minimally invasive surgical technique, applied under local anaesthesia, allowing the patient to return home on the same day of the operation.
What are the advantages of this method?
There many obvious advantages of percutaneous discoplasty with Discogel for the treatment of problems concerning intervertebral disc hernia, some of which are:
- The technique is percutaneous and does not involve surgery.
- Patients are not required to undergo anaesthesia.
- There is no surgical incision, haemorrhage, inflammation risk or stitches that must be removed.
- More than one disc can be treated simultaneously.
- Patients don’t need to be hospitalized and can leave hospital after completion of the infusion.
- According to recent studies up to 90% of the patients who have undergone Discoplasty avoided serious and more painful surgical operations in the future (for example spinal fusion).
What are the disadvantages of this method?
A disadvantage, if it can be considered as one, is the fact that the procedure is conducted under only a little local anaesthesia, and therefore the patient is fully aware of the whole procedure.
When are patients discharged from hospital?
The whole procedure does not last more than 15 minutes and the patient leaves after 3 to 4 hours. Strenuous work must be avoided in the first week and the patient is able to return to a normal pain free life without. Re-examination is required one month, two months and in six months after the operation.
How much does the operation cost?
The cost of the operation is not insurmountable even in the present difficult financial times. On the contrary, I believe that it is relatively affordable for the majority of our fellowmen. When comparing the cost to that of spinal fusion, one can understand that it approximately corresponds to 1/3 to 1/4 of the price of spinal fusion.
What is your opinion about the future use of Discogel?
This is an innovative method, which has been monitored over a period of 5 years and the results are particularly encouraging. Having noted the effectiveness of its use abroad as well as in Greece, I believe that it constitutes a revolution in the field of spine surgery. In fact due to the way Discogel is structured it can prevent the need for a future surgical procedure.
What percentage of people that can undergo this method?
According to studies a percentage of 70-80% of people will experience lumbago (low back pain) at some point in their life. If this is due to an intervertebral disc then, with a few exceptions (for example a broken disc), a patient can undergo this method, provided that the symptoms persist for some time.
Do you recommend it as a bloodless and minimally invasive method?
I strongly recommend it to patients that fulfil all the criteria for such an operation.
What is spinal endoscopy and how does it contribute to the recovery of chronic discogenic lumbosciatica?
With this method the exact point and the cause of pathogeny is located and treated. The location is detected by inserting a fibre optic endoscope in the epidural area. The treatment is done by injecting medicine into the problem area, or by removing the hernia that puts pressure on the nerves of the disc. This is carried out with the use of a laser or stent. This technique is achieved with the use of specialized equipment, which has a dual channel guiding control that is inserted into the epidural area. Through one channel the fibre optic endoscope is inserted and through the other one either the medicine is injected or an electrode is inserted to remove the hernia from the disc that is putting pressure on the nerves. An endoscope is a necessary tool for the location of the cause of pain and the investigation of the anatomical structure of the epidural area, in order to ensure precision during the surgical procedure.
Intervertebral disc hernia
Chronic discogenic lumbosciatica
Failed Back Surgery Syndrome (FBSS)
Anatomical disorder of the sacrum
Anatomical disorder of the epidural area
Related pathological conditions of the patient
What is neuroplasty?
It is a method which offers relief from pain caused by chronic lumbosciatica, using a pioneering bloodless surgical technique. This method is carried out with a guided catheter that is inserted into the epidural area through the sacrum. With the appropriate movements the doctor guides the thin flexible importer to the area of the inflammation which is either in the abdominal or the epidural area, with the use of a C-arm. The design and functionality of the catheter offers the chance to inject the medication exactly into the point of the neuronic inflammation, performing adhesiolysis.
• No injury of the muscles is caused
• Minimal invasive method of decompression of the intervertebral discs
• Easy insertion into the epidural area to recover the cause of pain
• It offers the ability for simultaneous diagnosis and treatment
• No chance for Failed Back Surgery Syndrome (FBSS)
What is hernia treatment with radiofrequencies?
This treatment consists of the following stages:
First, an intravenous catheter is used in order to be able to administer sedative medicine to the patient
The patient’s skin is thoroughly cleansed.
Local anaesthesia is applied to the area that is going to be operated on.
With the help of actinoscopy equipment a special needle is led into the area of the kidney.
A small portion of electric current passes through the needle at a safe distance from the nerves. This current replicates the patient’s pain and gives them a tingle on the neck or the waist.
Following that, the nerves will be numbed throughout the time that pain is replicated.
Radio waves are utilized in order to warm the needle and cause a heat interruption to stop the nerve sending pain messages to the brain.
The procedure is repeated for other nerves requiring treatment.
The patient returns home later the same day.