Histologic changes at the intervertebral disc tissue after laser nucleotomy; [Lazer nükleotomi sonrasi{dotless} i̇ntervertebral disk dokusunda histolojik deǧişiklikler]

Ösün A.; Samancioǧlu A.; Temiz P.; Temiz C.; Sayin M.

Histologic changes at the intervertebral disc tissue after laser nucleotomy; [Lazer nükleotomi sonrasi{dotless} i̇ntervertebral disk dokusunda histolojik deǧişiklikler]

Date

2013

Authors

Abstract

Minimally invasive surgical techniques have become widely used for lumbar disc disease. Each of these techniques have a different physical effect in terms of retracting the prolapsed disc tissue and decompressing the adjacent nerve root by reducing the intradiscal pressure. Various types of laser generators with different wave lengths and electrode systems have been used for percutaneous laser disc decompression (PLDD). There are numerous studies regarding the clinical effectiveness of PLDD but histologic parameters which can prove the effectivity are few. Three patients with L4-5 disc prolapsus had undergone open microdiscectomy three months after PLDD because of the unsatisfactory results. The disc tissues were evaluated histologically. Fibrous fibrillary degeneration, integrity deformation of the fibres and chondrocyte proliferation were seen at the site of the microdiscectomy tissue. Previously laser irradiated disc materials had more severe fibrillary degeneration and the chondroid component degeneration was significant. In addition, degenerative calcification and massive necrosis of the chondrocytes were seen. Changes in fibronectin, tissue inhibitors of metalloproteinases (TIMP) and matrix metalloproteinases (MMPs) of the disc tissue were examined with immunohistochemical dyes. As a result, we found that PLDD causes a decrease in the water content of the disc tissue, hyaline degeneration, fibrillary destruction and chondrocyte depletion. Immunostaining showed that the extracellular matrix was effected, the metalloproteinase activity and protein compound of the extracellular matrix had changed.The findings were discussed in light of the literature.