title: Combined Use of High Radiofrequency Disk Ablation, Annulus Modulation, and Manual Nucleotomy in a Patient with Extruded Disk Herniation.
abstract: Different minimally invasive procedures are used to treat lumbar disk herniation. It is important to differentiate these techniques due to their specific effects and the disparate technical issues associated with each. This report describes a successful case involving the use of mechanical decompression in conjunction with radiofrequency ablation to treat a patient with pain and neurological deficits due to an extruded disk hernia.
  
  
  
  A 43-year-old male had magnetic resonance imaging (MRI) demonstrating an extruded disk herniation in the left foraminal region, compression at the left spinal nerve root, and obliteration of the left foraminal entrance of the L5-S1 distribution. In the operating room, sufficient disk material was removed using grasping forceps, and then, the Disc-FX system with a Trigger-Flex probe (Elliquence, Baldwin, NY, U.S.A.) was inserted. Modulation of the annulus was performed in bipolar hemo mode, and nucleus ablation was conducted in bipolar turbo mode within a 1.7-MHz frequency range. Among the available minimally invasive techniques, newly developed technologies may become important treatment options if they enable faster rehabilitation, lower rates of recurrence, shorter hospital stays, and reduced medical costs.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Sakarya University Medical School, Sakarya, Turkey.
authors.forename: Serbülent Gökhan
authors.identifier: 0000-0001-9263-7823
authors.initials: SG
authors.lastname: Beyaz
authors.affiliation: Department of Orthopaedic and Traumatology, Sakarya University Medical School, Sakarya, Turkey.
authors.forename: Mustafa Erkan
authors.initials: ME
authors.lastname: İnanmaz
authors.affiliation: Department of Anesthesiology and Pain Medicine, Sakarya University Medical School, Sakarya, Turkey.
authors.forename: Ezgi Şen
authors.initials: EŞ
authors.lastname: Zengin
authors.affiliation: Department of Anesthesiology and Pain Medicine, Sakarya University Medical School, Sakarya, Turkey.
authors.forename: Ali Metin
authors.initials: AM
authors.lastname: Ülgen
mesh_terms: D055011:Ablation Techniques; D000328:Adult; D017587:Diskectomy, Percutaneous / Q000379:methods*; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000628:therapy*; D008159:Lumbar Vertebrae / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D010147:Pain Measurement; D011846:Radio Waves; D016896:Treatment Outcome
keywords: annulus modulation; disk decompression; disk herniation; extruded disk; nucleotomy; radiofrequency disk ablation