title: Percutaneous disc decompression with nucleoplasty-volumetry of the nucleus pulposus using ultrahigh-field MRI.
abstract: OBJECTIVE
  To evaluate changes in nucleus pulposus volume as a potential parameter for the effects of disc decompression.
  
  
  METHODS
  Fifty-two discs (T8 to L1) were extracted from 26 pigs and separated into thoracic (T8 to T11) and thoracolumbar discs (T12 to L1). The discs were imaged using 7.1 Tesla ultrahigh-field magnetic resonance imaging (MRI) with acquisition of axial T2-weighted turbo spin-echo sequences for determination of baseline and postinterventional nucleus pulposus volumes. Volumes were calculated using OsiriX® (http://www.osirix-viewer.com). After randomization, one group was treated with nucleoplasty, while the placebo group was treated with an identical procedure but without coblation current. The readers analyzing the MR images were blinded to the kind of procedure performed. Baseline and postinterventional volumes were compared between the nucleoplasty and placebo group.
  
  
  RESULTS
  Average preinterventional nucleus volume was 0.799 (SD: 0.212) ml. Postinterventional volume reduction in the nucleoplasty group was significant at 0.052 (SD: 0.035) ml or 6.30% (p<0.0001) (thoracic discs) and 0.082 (SD: 0.042) ml or 7.25% (p = 0.0078) (thoracolumbar discs). Nucleoplasty achieved volume reductions of 0.114 (SD: 0.054) ml or 14.72% (thoracic) and 0.093 (SD: 0.081) ml or 11.61% (thoracolumbar) compared with the placebo group.
  
  
  CONCLUSIONS
  Nucleoplasty significantly reduces thoracic and thoracolumbar nucleus pulposus volumes in porcine discs.
authors: Outpatient Clinic for Orthopedics and Orthopedic Surgery, University Medicine Greifswald, Greifswald, Germany. richard.kasch@uni-greifswald.de
authors: Richard
authors: R
authors: Kasch
authors: Birger
authors: B
authors: Mensel
authors: Florian
authors: F
authors: Schmidt
authors: Wolf
authors: W
authors: Drescher
authors: Ralf
authors: R
authors: Pfuhl
authors: Sebastian
authors: S
authors: Ruetten
authors: Harry R
authors: HR
authors: Merk
authors: Ralph
authors: R
authors: Kayser
mesh_terms: D000818:Animals; D019299:Decompression, Surgical / Q000295:instrumentation / Q000379:methods; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging / Q000601:surgery; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D011859:Radiography; D013552:Swine