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首页> 外文期刊>Spine >Temperatures within the lumbar disc and endplates during intradiscal electrothermal therapy: formulation of a predictive temperature map in relation to distance from the catheter.
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Temperatures within the lumbar disc and endplates during intradiscal electrothermal therapy: formulation of a predictive temperature map in relation to distance from the catheter.

机译：椎间盘内电热疗法期间腰椎间盘和终板的温度：制定与导管的距离有关的预测温度图。

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摘要

STUDY DESIGN: Temperatures were measured in human cadaveric lumbar discs during intradiscal electrothermal therapy. OBJECTIVES: To determine if sufficient temperatures for collagen denaturation and nociceptive ablation can be achieved at clinically significant distances from the intradiscal electrothermal therapy heating catheter. SUMMARY OF BACKGROUND DATA: Previous cadaveric studies have contested the ability of the intradiscal electrothermal therapy catheter to produce sufficient temperatures to denature collagen and cause neural ablation within the posterior anulus of the disc. However, these experiments used clinically unrepresentative device placements along the anterolateral anulus. METHODS: Intradiscal electrothermal therapy was performed in 14 human cadaveric discs. Devices were inserted using a standard posterolateral approach to orient the heating catheter along the posterior anulus. Temperature recordings were collected using multiple sensors placed along the posterior anulus, anterior anulus, and endplates. RESULTS: Temperatures greater than 60 C and 65 C were achieved in 14 and 5 specimens, respectively, at distances up to 2 mm from the catheter. Between 2 and 4 mm, more than 60 C was achieved in all specimens. More than 45 C was achieved in all specimens at distances of 9 to 14 mm from the device. CONCLUSIONS: Temperatures sufficient for collagen denaturation and nociceptive ablation were detected at distances greater than previously documented. These data suggest that intradiscal electrothermal therapy's proposed heat-dependent mechanisms of action are achievable in most discs. Among other factors, interspecimen variability of maximum temperatures may help explain the somewhat inconsistent clinical results following intradiscal electrothermal therapy.
机译：研究设计：在椎间盘内电热疗法期间测量人尸体腰椎间盘的温度。目的：确定在距椎间盘内电热疗法加热导管的临床显着距离处，是否可以达到足够的温度进行胶原蛋白变性和伤害性消融。背景数据摘要：先前的尸体研究对椎间盘内电热治疗导管产生足够的温度以变性胶原蛋白并引起椎间盘后环内神经消融的能力提出了质疑。但是，这些实验沿前环无临床意义的装置放置。方法：对14只人体尸体椎间盘进行了电热疗法。使用标准的后外侧入路插入器械，使加热导管沿后肛门环定向。使用沿后环，前环和终板放置的多个传感器收集温度记录。结果：在距导管最多2 mm的位置，分别有14个和5个样本的温度分别达到60 C和65 C以上。在2至4 mm之间，所有样品的温度均超过60C。距设备9到14 mm的距离，所有样品均达到45 C以上。结论：在比以前记录的距离更大的距离处检测到足以使胶原蛋白变性和伤害性消融的温度。这些数据表明，在大多数椎间盘中均可实现椎间盘内电热疗法提出的热依赖性作用机制。除其他因素外，最高温度的标本间差异可能有助于解释在椎间盘内电热疗法后临床结果有些不一致。

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