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PubMed · 11724257

CT-guided percutaneous laser disk decompression (PLDD) for cervical disk hernia.

J Harada·M Dohi·K Fukuda·H Nakazaki·T Koyama·T Abe
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Abstract

OBJECTIVE: Percutaneous laser disk decompression (PLDD) is an effective treatment for bulging or protruding disk. The aim of this study was to present a method of PLDD for cervical disk hernia under CT guidance and to evaluate the efficacy and safety of this procedure. MATERIALS AND METHODS: Seven patients with radiculalgia caused by cervical disk hernia were treated overnight by PLDD. A laser fiber was inserted through an 18 G needle into the target disk under CT guidance. A Nd-Yag laser (1,064 nm) was used for ablation. A CT scan was obtained every 60 joule (J) at the slice of the target disk to visualize the vaporized area during the procedure. The Japan Orthopedic Association (JOA) score of cervical radiculopathy (full score 15) and MacNab criteria were used for assessment of treatment response. RESULTS: Puncture of the needle to the target disk was safely performed under CT guidance. The total dosage of laser ablation ranged from 120 to 500 J (average, 266 J). The overall success rate according to MacNab criteria was good in all cases. No complications were observed in our series. CONCLUSION: The CT-guided technique provides safe, accurate PLDD for cervical disk hernia. PLDD for cervical disk hernia shows promise in the management of radiculalgia.

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Cervical VertebraeFemaleHumansIntervertebral Disc DisplacementLaser TherapyMaleMiddle AgedTomography, X-Ray ComputedJournal Article

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J Harada, M Dohi, K Fukuda, H Nakazaki, T Koyama, T Abe. CT-guided percutaneous laser disk decompression (PLDD) for cervical disk hernia.. https://pubmed.ncbi.nlm.nih.gov/11724257/

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PubMed2007

Surgical treatment of cervical kyphosis in Larsen syndrome: report of 3 cases and review of the literature.

STUDY DESIGN: A retrospective case series. OBJECTIVE: To review the surgical results for midcervical kyphosis in 3 cases with Larsen syndrome, and to discuss the choice of surgical treatments. SUMMARY OF BACKGROUND DATA: Cervical kyphosis is the most hazardous and serious manifestation of Larsen syndrome due to the risk of life-threatening paralysis, and thus usually requires surgical treatment. However, little information has been reported concerning surgical treatments for this challenging condition. METHODS: Three patients with Larsen syndrome were surgically treated for midcervical kyphosis at our institution. RESULTS: An infant with mild cervical kyphosis was successfully treated with posterior arthrodesis using a halo immobilization, and anterior vertebral growth with a mature posterior fusion mass resulted in spontaneous correction of the kyphosis. In the remaining 2 infants with myelopathic symptoms due to severe and structural kyphosis, anterior decompression and fusion via a lateral approach followed by posterior fusion with segmental spinal instrumentation and halo immobilization resulted in improved neurologic symptoms and solid fusion. CONCLUSIONS: Posterior spinal fusion is only indicated for patients with mild and flexible cervical kyphosis, and anterior decompression and circumferential arthrodesis is required for patients with severe kyphotic deformity, who usually develop myelopathic symptoms. Anterior surgery for such a small patient with severe kyphosis involves much higher risk of spinal cord injury during decompression maneuvers and difficulty in stabilization of the reconstructed cervical spine. Therefore, all patients with Larsen syndrome should be screened with radiographs at the first visit to detect cervical kyphosis early so that posterior alone fusion is possible.

Cervical Vertebrae↗