What is a Percutaneous Disc Augmentation?
Following an extensive clearance of the degenerate material within the disc by Endoscopic Laser Decompression & Foraminoplasty and flexible endoscopic intradiscal discectomy a cavity is produced. This potential can be measured. The implant is termed a Bionucleoplasty. The Bionucleoplasty of comparable size is inserted in to the cavity through the approach tube. The Bionucleoplasty with advanced technology alters in shape and height to fill the cavity and ultimately the disc height is progressively restored.
When to Accept a Percutaneous Bionucleoplasty?
We try to restrict fusions to the end stage of treatment of the degenerate spine because fusion causes acceleration of degeneration in the adjacent discs - the "Domino effect".
The Bionucleoplasty studies to date indicate that height restoration is associated with restoration of function in terms of movement range and load handling through the disc. The Bionucleoplasty should functionally rejuvenate the segment. Ultimately we consider that it should be inserted in to every disc in which the acceptance volume is increased beyond 1.5 mls.
At present we are reserving application to patients with large acceptance (advanced disc degeneration) volumes and back pain or large acceptance volumes and lateral recess stenosis.
After proving studies in the lumbar spine then the implant will be used in the cervical spine.
Patients will undergo the requisite primary procedure of Endoscopic Laser Decompression & Foraminoplasty with flexible endoscopic intradiscal discectomy followed by Bionucleoplasty on a daycase basis.
Our studies indicate that the Bionucleoplasty can be removed by laser techniques should it deteriorate and be replaced by another Bionucleoplasty. Should this prove inappropriate we will then use all the conventional options of soft or rigid fusion to carry out a definitive if physiologically imperfect resolution.