Medical

New technique both refills and patches herniated discs

New technique both refills and...
The procedure takes only five to 10 minutes, after an initial discectomy
The procedure takes only five to 10 minutes, after an initial discectomy
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A piece of the collagen/riboflavin gel, after being solidified by exposure to light
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A piece of the collagen/riboflavin gel, after being solidified by exposure to light
The procedure takes only five to 10 minutes, after an initial discectomy
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The procedure takes only five to 10 minutes, after an initial discectomy

Not only are herniated discs painful and debilitating, but treatments for them leave something to be desired. A new technique, however, may be more effective than anything that's come before.

Between each of our vertebra is a shock-absorbing spinal disc, which consists of a rubbery exterior known as the annulus and a jellylike "filling" called the nucleus. Herniated discs occur when a tear in the annulus allows some of the nucleus to leak out and bulge into adjacent nerves, irritating them.

Surgical treatments typically involve either removing the protruding nucleus and then sewing up the tear in the annulus – leaving the disc "deflated" – or refilling the disc with a replacement material, which may eventually also leak out through the unpatched hole.

Led by Cornell University's Prof. Lawrence Bonassar, scientists from the US and Italy have developed a procedure that combines the refilling with the patching. It's performed after a discectomy, which is the standard process for removing the leaked nucleus material.

Initially, a hyaluronic acid gel is injected into the disc, essentially reinflating it. Next, a collagen/riboflavin gel is applied to the tear in the annulus. When that gel is subsequently exposed to a high-intensity light source, the photoactive riboflavin is activated. This causes the collagen fibers to cross-link with one another, forming a solid patch. Over time, cells from the surrounding annulus migrate into that patch, gradually replacing it with natural biological tissue.

A piece of the collagen/riboflavin gel, after being solidified by exposure to light
A piece of the collagen/riboflavin gel, after being solidified by exposure to light

The process reportedly only takes five to 10 minutes (after the initial hour-long discectomy), and has already been successfully trialed on sheep.

"This is really a new avenue and a whole new approach to treating people who have herniated discs," says Bonassar. "We now have potentially a new option for them, other than walking around with a big hole in their intervertebral disc and hoping that it doesn’t re-herniate or continue to degenerate. And we can fully restore the mechanical competence of the disc."

A paper on the research was recently published in the journal Science Translational Medicine.

Sources: Cornell University, American Association for the Advancement of Science via EurekAlert

9 comments
xs400
Wondering if a similar technique could be developed for knees.
Worzel
I've been living with herniated disc for approaching 50 years, and can confirm the, '' painful and debilitating,'' part. However, by the time this procedure is in mainstream treatment, I'll probably be past caring, [or living.] @xs400; knees are different from spinal discs so it's probably not appropriate, but I'm sure there are alternative procedures that are being used.
1stClassOPP
I had surgery for a ruptured disc about 26 years ago. The operation took about six to eight hours, spent ten days in hospital and took about eight months to recover enough to get back to work. I think advancements in medical procedures have since streamlined somewhat,. Any further advancements in remedial treatment should be very welcome by anyone suffering from this type of back problem.
RFM
@xs400: I thought EXACTLY the same thing. Facing either one or two "total knee's" in the near future, I would love an alternative. What "Worzel might be true about knees, however I could envision [read: dream] a riboflavin gel sack inflated inserted to replace a meniscus with a more robust injection. I've researched: there are currently no generally successful alternatives to total knee replacement. Only ~60% of those who receive hyaluronic acid gel knee injections are satisfied with the outcome post-op, according to my ortho doc.
tangential
I am surpised that they don't insert some T-cells as well.
Kpar
I have not been diagnosed with a herniated disc, however I have bulging discs and was scheduled last year to have the discs replaced with titanium spacers- a not inconsequential surgery.

This new technology is certainly welcome, but I have a word of advice for lower back pain and sciatica sufferers: turmeric.

I noticed that turmeric is a main ingredient in most of the holisitic pain treatments advertised on the radio. When I saw a "deal" online for a three month supply, I figured "what the heck, what have I got to lose?" and spent the one hundred bucks.

I took the capsules twice a day for three weeks without result, but one morning I woke up without pain, and, without crutches for the first time in months, I walked my dog over a mile.

I canceled my back surgery. I have been mainly pain free since. A side note- I was out of town and realized I had run out of turmeric- I went to the local Wal-Mart and got a bottle (same count, same dosage- a one month supply) for $15! And it worked just as well!

This will not work for everyone, I am sure, but if you're facing surgery you'd be nuts not to try it. Check with your doctor and/or pharmacist for drug interactions.
Pancho Molina
I know is too early , but looks that a dream is coming true.
fugumagoo
Amazing. I'd read about this a few years ago and hadn't heard updates but this is a great step forward. Kudos to all those involved. Like other commenters, I have had a herniated disc before and it's awful. Anything to help others recover better should be welcomed and applauded.
Norman Welch
Dr. Kevin Pauza of Tyler, Texas pioneered a similar treatment about a decade ago with little fanfare. Rather than using light to set the repair material, his method utilizes a 2 part cartridge injection system similar to epoxy. His success rate has been exceptionally high, obviously and unfortunately his discovery posed a threat to the current medical/financial system. Google him and his work, it's rather interesting.