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Extraction of prolapsed disc by extractome

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Extraction of prolapsed disc by extractome

When do we resort to disc suction procedure?

Non-surgical management of disc prolapse by disc suction is a step to remove disc prolapse which occurs due to many factors we experience every day, but in some circumstances and mostly with persistent cause the outer layer extends outside the disc site and the nucleus pulposus accompanies it, causing compression on nerve roots and leg pain, also inflammatory substances are secreted from the disc causing nerve swelling and inflammation.

Would we prefer lumbar disc surgery or disc suction procedure?

Before emergence of recent and advanced methods for management of disc prolapse using interventional radiology or disc suction concept, the patient had only 2 options:

  1. Medical treatment and physiotherapy (often not a cure but a temporary relief of pain).
  2. Surgical excision of herniated disc with its concerns regarding surgical risks on the body.

And here is the role of disc suction for patients not improving on medical treatment and still haven't reached the stage requiring surgery, Suction intervention is the optimal approach for many reasons:

  1. It helps the patient get rid of his pain rapidly without waiting.
  2. It spares him reaching progressive stages.
  3. It protects the nerve from further compression for longer duration and further neural deficit.

What are symptoms of disc prolapse that needs disc suction?

A patient with disc prolapse (at first and second stages of disc prolapse) is considered the best candidate for disc suction; as evacuating the disc nucleus will reduce pressure inside it, thus relieving the intensity of pressure on nerve plexus and fibrous wall, leading to great improvement of pain in the back and leg.

Regarding patients in (third and fourth stages) which develop after tear of the fibrous wall, suction will not retrieve parts of the nucleus that have separated and moved inside the spinal canal or migrated away, and such migrated parts need to be extracted surgically or by light endoscopy. And usually patients seek medical advice in these stages when pain starts.

Many patients don't simply or easily accept open surgery as long as there is even a small hope of medical treatment or physiotherapy.

Unfortunately, the patient doesn't know that these treatments only work to delay surgery as the disc will sooner or later progress to the third and fourth stages where surgery is the only available option.

Therefore we resort to diagnosing cases before using disc suction technique after confirmation by MRI imaging and examination of the patient, we decide performing interventional disc suction.

How is lumbar or cervical disc suction performed?

It is performed under local anesthesia and interventional radiology, and surely it is performed inside operation room under complete sterilization, and also one of disc suction advantages is that the used device is for single use only with one patient then becomes disposed following safety measures.

Disc fragmentation and suction procedure:

Disc suction procedure is performed using a small needle for local anesthesia, as the device is introduced through a needle of tiny diameter under guidance of radiology to inside the herniated part only, it fragments this part of the herniated disc and exits to its container inside the device, as illustrated in videos of disc suction procedure, and this non-surgical procedure takes around 20 minutes, and it is very safe, without any adverse effects and with very high success rates.

Usually we also manage inflamed nerve roots by nerve root injection and radiofrequency ablation, and so we will have managed both the pain and its cause.

The patient will go home after one hour maximum, and goes back to work after a few days with full activity.

Disadvantages of Disc suction procedure:

There are no disadvantages of disc suction procedure; as success rates depend on correct diagnosis and appropriate management, and one of the best advantages of disc suction procedure in pain management center is full safety and going back to work soon, without wound or tear in the skin or muscles that patients suffer from after surgical operations, and not using general anesthesia.

The most important advantages of interventional non-surgical management are:

  • It is done under local anesthesia.
  • A small puncture without scars.
  • No part of the spine is removed.
  • No rupture in back muscles.
  • Dynamic stability of the spine is maintained.
  • No need for surgical sutures.
  • It is done outside the spinal canal.
  • No post-operative fibrosis or adhesions in the spinal canal.
  • It takes about 20 minutes.
  • The patient can go back to work within one week, in opposite to surgery which needs general anesthesia with removal of parts of the spine, and the possibility of post-operative fibrosis in the spinal canal which can compress nerve roots, and this can be difficult to treat and can affect the patient's activity and practicing his work and life activities.