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Abstract
Please confirm that an ethics committee approval has been applied for or granted: Not relevant
Background and Aims Trans-sacral epiduroscopic plasma decompression (SEPD) refers to the procedure of relieving pressure on epidural structures by utilizing a plasma reaction, conducted through a trans-sacral route. Using bipolar radiofrequency energy for ablation and coagulation, known as the Coblation® technique, it is feasible to decrease intradiscal pressures and disc volume by removing disc material. This study represents the inaugural research on SEPD utilizing a plasma catheter in animals. Its primary objective is to validate the safety of SEPD.
Methods Epiduroscopes were inserted through the sacral hiatus in two pigs and then advanced to the lumbar segment’s epidural space. (Figure 1) A plasma catheter was inserted through the working channel of the epiduroscope. This catheter was then placed into the epidural structures, where ablation was conducted using a plasma reaction. Following plasma ablation, the walking and physical activity of the two pigs were assessed. One month after the plasma ablation, autopsies were conducted. (Figure 2)
Results Following the experiments, the pigs were subjected to tests for allodynia to assess nerve injuries. However, neither abnormal motor behavior nor any signs of pain, allodynia, or paresis were observed in the pigs. During the autopsy, the spinal cord and spinal nerve roots were dissected and examined histologically under a microscope. However, no thermal damage was observed in the nervous tissues. (Figure 3)
Conclusions In conclusion, SEPD did not demonstrate severe complications in pigs. This suggests that SEPD could be a promising method for spinal decompression in humans.