Percutaneous lumbar diskectomy using rotating pliers system

Objective: To explore the feasibility of using rotating pliers system for treating lumbar disc herniation with concomitant prolapse. Methods: Ex vivo incision experiment was performed on 8 lumbar discs of 2 pigs using rotating pliers. Clinical application included 12 patients of lumbar disc herniation shown by CT or MRI. 40% herniations gave enough pressure on dural sac with concomitant prolapse of different degrees. The symptoms and image finding were concordant. The herniated nucleus pulposus were resected using rotating pliers system, MacNab standard was applied for the clinical evaluation. Results: The ex vivo experiments and clinical application were successful. Clinical application showed CR in 4 patients (33.3%), PR in 5 patients (41.7%) and NR in 3 patients (25.0%). CT demonstrated the herniated disk tissue retraction of different degrees in CR and PR patients, together with decrease in CT attenuation number, ranging from 8-30 HU, 18 ± 5 HU in average but no changes in NR patients. Conclusions: Percutaneous lumbar diskectomy is safe and effective to treat lumbar disc herniation with concomitant prolapse by using rotating pliers systems and thus extending the PLD application