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Comparative sudy of surface displacement in discs following chemonucleolysis and lasernucleotomy
Author(s) -
Kutschera HansPaul,
Lack Werner,
Buchelt Martin,
Beer Rudolf
Publication year - 1998
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/(sici)1096-9101(1998)22:5<275::aid-lsm3>3.0.co;2-m
Subject(s) - stiffness , displacement (psychology) , deformation (meteorology) , cadaver , biomedical engineering , materials science , medicine , anatomy , surgery , composite material , psychology , psychotherapist
Background and Objective Dynamic changes of the dorsolateral protrusion site have been postulated to play an important role in the therapeutic effect of lasernucleotomy and chemonucleolysis. Basic biomechanical effects of the anulus after lasernucleotomy and chemonucleolysis are investigated. Study Design/Materials and Methods: This study evaluates the in vitro bulging of lumbar discs comparing lasernucleotomy and chemonucleolysis. The horizontal displacement at the ventral and dorsolateral surface of 20 cadaver discs were tested by application of a continuously increasing axial deformation before and after therapy. The increase in horizontal displacement due to this longitudinal deformation was measured. Results Bulging was significantly lower at the puncture site of the chemonucleolysis needle as well as at that of the laser trocar. Significantly reduced bulging of the anulus was observed after chemonucleolysis. Slightly increased bulging was observed after lasernucleotomy in the total posterior region. There was a tendency to decreased stiffness after chemonucleolysis and a significantly decreased stiffness after lasernucleotomy. Conclusions The in vitro effect of lasernucleotomy seems to be based on reduction of the stiffness by distributing the load all over the anulus, whereas chemonucleolysis reduces bulging. Lasers Surg. Med. 22:275–280, 1998. © 1998 Wiley‐Liss, Inc.