Evaluation of the resection efficiency and safety of an enhanced power plasma generator using cadaveric intervertebral discs

Youngki Hong; Sung-Young Yoon; Sangho Sohn; Nack Hwan Kim; Yushin Kim; Sangheon Lee

doi:10.1007/s13534-022-00253-9

Evaluation of the resection efficiency and safety of an enhanced power plasma generator using cadaveric intervertebral discs

Biomed Eng Lett. 2022 Dec 19;13(1):57-64. doi: 10.1007/s13534-022-00253-9. eCollection 2023 Feb.

Authors

Youngki Hong¹, Sung-Young Yoon^{2

3}, Sangho Sohn⁴, Nack Hwan Kim⁵, Yushin Kim¹, Sangheon Lee^{5

6}

Affiliations

¹ Department of Sports Health and Rehabilitation, College of Health Science, Cheongju University, 298, Daesung-Ro, Sangdang-Gu, 360-764 Cheongju, South Korea.
² Samsung Mechatronics R&D Center, SEC, 1, Samsunggjeonja-ro, Hwaseoung-si, Gyeonggi-do South Korea.
³ Plasma Technology Research Center, National Fusion Research Institute, 54004 Gunsan, South Korea.
⁴ Department of Preventive Medicine, Korea University Medical Center, 126-1, Anam-Dong 5Ga, Seongbuk-Gu, 136-705 Seoul, South Korea.
⁵ Department of Physical Medicine and Rehabilitation, Korea University Medical Center, 126-1, Anam-Dong 5Ga, Seongbuk-Gu, 136-705 Seoul, South Korea.
⁶ Spinal Diagnostics and Treatment Center, 901 Campus Dr, 94015 Daly City, CA USA.

Abstract

Plasma energy has been used to provide minimally invasive interventional treatment for spinal problems. However, this procedure has been used for limited indications mainly because of its small resection range. To overcome this problem, we designed the enhanced power plasma device. This device seeks to maximize the resection area by modifying the electrode arrangement and enhancing the maximum electric power. The purpose of this study is to assess the efficiency and safety of this newly designed plasma generator, a device for percutaneous disc decompression. We performed an intradiscal procedure on 7 fresh human cadaver lumbar spine specimens using the enhanced power plasma under C-arm fluoroscopic guidance at various voltages. As a result, the volume of the removed area was proportional to the applied magnitude of the electric power level. In particular, under the high-power level condition after 500 s treatment, nearly the entire nucleus pulposus was eliminated. The generated plasma density also tends to grow along with the given electric power. The highest level of temperature rise did not exceed the level that would lead to degeneration in the collagen tissue of the intervertebral disc. Histopathologic examination also demonstrated that there was no thermal damage to the surrounding neural tissues. In conclusion, we speculate that the concepts of this newly designed enhanced plasma generator could be applied to remove huge disc materials without thermal or structural damage to the adjacent target tissues in future spine clinics.

Keywords: Back pain; Herniated intervertebral disc; Interventional spine procedure; Percutaneous plasma disc decompression.

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