By Alexander Germanis
As recently as the early 1980s, a single portable computer weighed 25–30 pounds and did not have enough memory to save a single page document. Now, the average schoolchild carries a computer/telephone/camera in their pocket with more computing power than hundreds of those electronic back breakers combined.
It has long been the goal of those making technological advances to not only improve the quality of work done by that technology but to dramatically reduce the size of the technology as well. This is true whether talking about computers and telephones or medical instruments and the way in which they are used in surgical procedures, such as treating intervertebral disc herniation.
Founder of the Millennium Pain Center in Bloomington, Dr. Ramsin Benyamin, previously cited how the spectrum of treatment for disc herniation has widened over the years. As advances have been made in the field, Dr. Benyamin says, “the techniques [have become] less invasive, with smaller incisions — using endoscopes rather than making big incisions and cutting the back muscles.”
And now, relieving disc herniation is in the percutaneous era — meaning, the work is done not through an incision in the skin at all but rather through a small puncture through the skin via a needle.
Then, “guided by live X-ray, or fluoroscopy,” the doctor explains, “the needle is maneuvered into the disc.” However, the needle is merely an “introducer,” he says. This means the needle acts as the conduit through which the very small instruments performing the actual work are given access to the inside of the disc.
Dr. Benyamin expounds on the way in which these myriad devices carry out the same job: “Some are like a Roto-Rooter — they extract the disc material,” he says. “Some tools vaporize it — some use a laser to vaporize it, some use different kinds of high energy to vaporize it. Some use high water pressure to extract the disc material from inside of the disc. We offer all of those and these are all needle (percutaneous) and outpatient procedures.”
Once again, with a soft-shelled egg being analogous to the intervertebral disc, the doctor illustrates these percutaneous procedures are, “in contrast to the surgical techniques. Here you remove parts of the disc from inside,” he says, “so you maintain the structure of the disc ‘shell.’ So, instead of using something like pliers to remove the disc herniation from outside the shell, here you poke the egg with the needle, introduce a small instrument inside the egg and then remove the disc material from inside. By doing this you are helping to maintain the structural integrity of the ‘eggshell.’”
Maintaining the overall integrity of the disc and reducing the loss of water content of the disc is paramount to stave off future disc herniations or worse, the need for spinal fusion.
But there are other, non-surgical methods or “new concepts,” as Dr. Benyamin puts it, “that are currently under clinical trial protocol. One of them is to treat the disc herniation by shrinking the disc. That is achieved by putting a tiny needle into the disc and injecting a small amount of chemical that will shrink the disc from within.”
Another method is carried out with “a medication that is not even new, but the way we use it is different,” the doctor adds. In addition to treating a slew of other ailments, the drug known as clonidine has also been used for treating spinal pain for more than 20 years. Now, clonidine, in the form of time-release pellets, is used as a substitute for steroids in an “epidural steroid injection.”
“The third one is Nugenix,” Dr. Benyamin concludes. “That is also an FDA approved product, but we’re doing a clinical trial of injecting this medicine intravenously to treat sciatic pain.”
Additional advantages to the aforementioned outpatient percutaneous procedures and clinical trials, also include: no incision, no general anesthesia, faster procedural time, faster recovery and less risk of complications, there is the fact that patients now have more and “newer options,” Dr. Benyamin says. “Options that are not your old style do-nothing medication or invasive surgery. There’s an option in between those two extremes that is less costly; and that’s a big thing these days.”
This concludes our 4-part series of articles on intervertebral disc herniation. If you missed the previous articles, you may read them online www.HealthyCellsBN.com or contact Cheryl Eash, 309-664-2524 or e-mail ceash7@gmail.com.
Millennium Pain Center, located at 1015 S. Mercer Ave. in Bloomington, provides the most advanced and comprehensive pain management for a wide variety of conditions. Drs Benyamin and Vallejo have been selected among 70 of the Best Pain Physicians in America. For more information, you may contact them at 309-662-4321 or online at www.millenniumpaincenter.com.