THE EFFECT OF RADIOFREQUENCY ABLATION ON INTERVERTEBRAL DISC AFTER NUCLEOTOMY IN RATS

Piontkovsky V. K., Ashukina N. A., Malceva V. E., Ivanov G. V.

MORPHOLOGY

Scentific article

The prevalence of degenerative changes in the intervertebral disc and associated pain causes the development methods of minimally invasive therapy for minimize injuries during surgery and to obtain effective results. For microdiscectomy are used various methods in the case of intervertebral disc herniation. However, changes occur at the tissue level is unclear. The purpose of the study: to investigate the effect of radiofrequency ablation on damaged tissues of the intervertebral disc. Object and methods. The experiment was conducted on the 30 white laboratory rats, in which surgically reproduced the damage of the intervertebral disc of the lumbar spine (LII-LIII) by cutting annulus fibrosus and removing nucleus pulposus. Animals were divided into three groups of 10 each in each: in the “ablation” group, after the removal of the nucleus pulposus, radiofrequency ablation was applied locally (generator Elliquence Surgi-Max, bipolar mode, duration 1 s); in the group “laser” – laser vaporization (laser “Surgeon Lika”, power 4-6 W, dose 1000 J, duration 1 sec); in control – without influence. The histological analysis of sections of the lumbar spine in the frontal plane was performed at 30 and 45 days after surgery. In order to compare the indices in the groups, the relative areas of tissue regenerate in the traumatized intervertebral disc were used – the percentage of certain tissue from all located in the intervertebral gap. Results. In the control group, on the 30th day after nucleotomy, the absence of the lamellar structure of the annulus fibrous was detected almost throughout the intervertebral disc, and in the outer regions there was a growth of cartilaginous tissue. In the group “ablation”, for this term, territories with the stored structure of plates in the outer part of the annulus fibrous and with the invasion of the blood capillaries and connective tissue were noted. The larger area of the regenerate was cartilaginous tissue, the relative area of which was 1.3 times (p < 0,05) higher than the “laser” and the control. In the “laser” group in the annulus fibrous, as in the control, the loss of the lamellar structure was detected. Regenerate, as in the “ablation” group, was represented by cartilage and connective tissues. Relative area of connective tissue exceeded the index in the group “ablation” in 1.8 times (p < 0,05). The cartilaginous tissue, which was formed on the intervertebral gap for this term, had unevenly stained matrix in rats of all groups, with its bundles and sections of necrosis, and also the presence of chondrocytes clusters and uneven distribution of cells. For the 45th day in the control group, the formation of cartilage tissue was found, mainly in the outer regions of the injured intervertebral disc. In the group “ablation” an increase the area of cartilage tissue with layers of connective tissue of varying degrees of maturity in the place of the outer regions of the annulus fibrous is noted. In the group “laser”, as in the group “ablation”, the relative area of cartilage tissue has increased. The connective tissue formed in the intervertebral gap was predominantly dense. Its relative area exceeded the indicator in the group “ablation” in 2.1 times (p < 0,05). Conclusions. Local use of laser radiation and radiofrequency ablation contributes to the formation of connective and cartilaginous tissues in the intervertebral gap. In the case of laser vaporization in the area of injured intervertebral disc on the 45th day of the experiment, connective tissue prevailed, and in the case of radiofrequency ablation, cartilage, which can be considered as a more prognostic factor.

radiofrequency ablation, laser radiation, intervertebral disc, histology, rat

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«Bulletin of problems biology and medicine» Issue 4 Part 2 (147), 2018 year, 291-297 pages, index UDK 616.721.1-007.43-089.81]092.9(599.323.4)

10.29254/2077-4214-2018-4-2-147-291-297