The rowing stroke places a lot of stress on the lower back, thus leaving many competitive rowers dealing with lower back injuries. Although many young rowers present with bulging discs, annular tears, and inflamed joints, these problems often do not become surgical until later in life. A recent article in The Journal of Korean Neurosurgical Society discusses many implications of biotechnology in revolutionizing lumbar disc herniation surgery. Entitled “Strategies for Noncontained Lumbar Disc Herniation by Endoscopic Approach: Transforaminal Suprapedicular Approach, Semi-Rigid Flexible Curved Probe, and 3-Dimensional Reconstruction CT with Discogram”, Dr. Chae et al discuss the combination of imaging and surgical technology to increase the success rate and the ease of this particular surgery.
When a patient is diagnosed with a noncontained disc hernation, there is a distinct probability that the inside of the disc has fragmented and possibly moved around in the spine. With these types of herniations, the typical surgical methods are not always effective because of the placement of the disc fragments. Dr. Chae et al explain that they used 3D reconstruction CT images to determine the severity of the disc herniation and whether or not the fragments were contained. This allowed them to see whether or not the use of a semi-rigid flexible curved probe, made by RZ Medizin Technik GmBH in Germany, would help to extract the disc material so that the endoscope could reach the material and remove it from the body. The use of this type of probe allows the surgery to remain endoscopic (an incision of only 1 cm) even when the disc fragment has migrated into a place where it cannot be reached by the endoscope alone. In this study, 94.77% of the 145 patients had satisfactory results, and within that group, 99 patients reported excellent results.
Because of the variation in types of disc herniations, it is often difficult for doctors to determine what type of approach will be necessary to remove the disc fragment. This can make surgeries more difficult and possibly increase recovery time. Yet, according to this study, the use of 3D reconstruction CT allows surgeons to see exactly where the disc herniation has occurred and can determine what type of surgical technique and instrumentation will be necessary. Surgical tools like the semi-rigid flexibly curved probe can help mediate problems like disc fragment migration and also keep the surgery as simple as possible for the patient. These types of innovations can help to decrease the likelihood of needing revision surgery in the future by making sure that all of the disc fragments were successfully removed the first time around. Most athletes, especially rowers who place a lot of strain on their lower back, and commonly suffer from herniated discs, would welcome innovative techniques like this.
Thanks for sharing great insights about lumbar disc herniations. It was a worth post to read.
ReplyDeleteNice sharing and keep posting.