Kailash Kothari
Fortis Hospital, India
Title: Disc-FX, a minimally invasive treatment for contained/degenerated lumbar disc herniation
Biography
Biography: Kailash Kothari
Abstract
Back pain due to Lumbar Disc Disease is a huge burden on healthcare system. The treatment options range from physiotherapy to fusion surgery. A number of minimally invasive procedures have also been developed in the recent past for its management. Disc-FX is a new minimally invasive technique that combines multiple mechanisms to treat this percutaneous discectomy, nuclear ablation and annular modification. Literature on its role in the management of lumbar disc pathology is limited. We have treated 30 consecutive patients with the Disc-FX discectomy for back pain due to lumbar disc pathology non-responsive to non-operative treatment. Based on Magnetic Resonance Imaging (MRI) we divided patients in 2 groups – those with degenerative disc disease (DDD) and those with a contained lumbar disc herniation (CLDH). The patients with diffuse disc prolapsed, extruded and migrated disc, facet pain were excluded. Patients were evaluated pre and post operative at various intervals. The surgical technique involves proper skin markings, under local anaesthesia and minimal sedation ipsilateral insertion of Disc-FX cannula in the dorsal part of the disc (from disc pathology and painful side), under fluoroscopy guidance provocative discogram, manual removal of disc material, nucleus ablation and annulus modulation performed Disc FX RF electrode. Significant improvement was seen in all outcome measures in most patients. Few patients needed further open operative procedures. Early results after the Disc-FX procedure suggest that it s a good treatment option for patients with back pain due to lumbar disc herniation and degeneration, especially for those with DDD & CDD where conservative treatment fails. This procedure is good for both low back and leg pain due to lumbar disc disease. This procedure involves combined 3 in1 approach to treat disc pathology. This treatment method looks very promising and in future larger, longer prospective studies will be needed to evaluate its efficacy.