At the 11th Annual Orthopedic, Spine and Pain Management-Driven ASC Conference on June 13, Ara Deukmedjian, MD, chief executive officer and medical director of Deuk Spine Institute, gave a presentation on a new symptomatic cervical disc disease treatment, Deuk Laser Disc Repair. Deuk Laser Disc Repair is designed to be an alternative to anterior cervical discectomy and fusion.
Dr. Deukmedjian described the indications for performing the procedure, clinical process and patient outcomes.
1. Indications. Symptomatic cervical disc disease can cause discogenic neck pain, upper extremity pain, numbness, tingling and radicular symptoms. Patients that are candidates for Deuk Laser Disc Repair have failed to respond do conservative treatments, such as physical therapy.
Spine surgeons need to perform a discogram to determine the whether or not the source of pain is discogenic. A discogram will confirm the source of discogenic pain and determine the disc level. Cervical facet syndrome is a common cause of neck pain, though it can be clinically difficult to diagnose. Spine surgeons must rule out cervical face syndrome before deciding to perform Deuk Laser Disc Repair.
2. Clinical Process. Deuk Laser Disc Repair is a minimally invasive procedure done through an anterior cervical approach that can be performed in the outpatient setting. It is a motion-preserving technique that requires no implants or biologics. The patient is placed under general anesthesia and a 4mm skin incision is made. The procedure is transdiscal; it is performed with a fiber optic endoscope through a 1.2mm working channel. Patients can be discharged an hour after undergoing the procedure.
The first step of Deuk Laser Disc Repair is a selective partial discectomy. "Normally you can't see the damage caused by symptomatic cervical disc disease unless you take out the whole disc. We go through the disc and only remove only the damaged part," said Dr. Deukmedjian. Using a cannula and forceps, the damaged portion is removed. The second step is annular debridement, which is done using a laser, and the third step is a foraminoplasty.
3. Patient Outcomes. In a prospective cohort study of 66 consecutive patients and 111 treated discs, Deuk Laser Disc Repair showed 100 percent resolution of pain in 50 percent of the patients. "Patients did so well there was very little need for follow up care," said Dr. Deukmedjian. To date, the procedure has had no postoperative complications. Patients treated for discs at one or two levels have not shown different outcomes.
"We did find that in many patients with discogenic symptoms are not active due to their pain and begin to have facet pain from not moving their neck. Even those with facet syndrome had 86 percent improvement after surgery," said Dr. Deukmedjian. Two-thirds of the patients experienced 100 percent resolution from headaches cased by neck pain.
Deuk Laser Disc Repair is planned to undergo a prospective randomized study most likely in comparison to fusion. "Whenever you have a new technology, it takes time to gain traction, but the procedure is gaining interest," said Dr. Deukmedjian.
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1. Indications. Symptomatic cervical disc disease can cause discogenic neck pain, upper extremity pain, numbness, tingling and radicular symptoms. Patients that are candidates for Deuk Laser Disc Repair have failed to respond do conservative treatments, such as physical therapy.
Spine surgeons need to perform a discogram to determine the whether or not the source of pain is discogenic. A discogram will confirm the source of discogenic pain and determine the disc level. Cervical facet syndrome is a common cause of neck pain, though it can be clinically difficult to diagnose. Spine surgeons must rule out cervical face syndrome before deciding to perform Deuk Laser Disc Repair.
2. Clinical Process. Deuk Laser Disc Repair is a minimally invasive procedure done through an anterior cervical approach that can be performed in the outpatient setting. It is a motion-preserving technique that requires no implants or biologics. The patient is placed under general anesthesia and a 4mm skin incision is made. The procedure is transdiscal; it is performed with a fiber optic endoscope through a 1.2mm working channel. Patients can be discharged an hour after undergoing the procedure.
The first step of Deuk Laser Disc Repair is a selective partial discectomy. "Normally you can't see the damage caused by symptomatic cervical disc disease unless you take out the whole disc. We go through the disc and only remove only the damaged part," said Dr. Deukmedjian. Using a cannula and forceps, the damaged portion is removed. The second step is annular debridement, which is done using a laser, and the third step is a foraminoplasty.
3. Patient Outcomes. In a prospective cohort study of 66 consecutive patients and 111 treated discs, Deuk Laser Disc Repair showed 100 percent resolution of pain in 50 percent of the patients. "Patients did so well there was very little need for follow up care," said Dr. Deukmedjian. To date, the procedure has had no postoperative complications. Patients treated for discs at one or two levels have not shown different outcomes.
"We did find that in many patients with discogenic symptoms are not active due to their pain and begin to have facet pain from not moving their neck. Even those with facet syndrome had 86 percent improvement after surgery," said Dr. Deukmedjian. Two-thirds of the patients experienced 100 percent resolution from headaches cased by neck pain.
Deuk Laser Disc Repair is planned to undergo a prospective randomized study most likely in comparison to fusion. "Whenever you have a new technology, it takes time to gain traction, but the procedure is gaining interest," said Dr. Deukmedjian.
More Articles on Spine:
5 Often Neglected Risks of Offering Innovative Spine Surgery
3 Spine Surgeons on What Inspires Them to Continue Practicing in the Field
4 Challenges Today's Minimally Invasive Spine Surgeons Face