CTIDOR METHOD FOR SPILLED DISC
AND SPINE PAIN TREATMENT
Use of minimally invasive procedures on the spine.
For many years, spilled discs and pain in the spine were treated with open surgery, with the placement of screws and fixation on the spine; over time it was observed that this kind of surgery had many complications and little result, so treatments with minimally invasive surgery were started; With medical advances many simpler procedures have been developed that have shown better results. So with this vision since 2006, the year CTIDor was inaugurated, we have only performed the minimally invasive treatment on the spine. Our experience of more than 2000 thousand procedures performed, we have developed a little invasive treatment method with better results than open surgery . Our method draws attention: the speed of treatment, the good recovery of the patient and the reduction of more than 90% in the number of open surgeries. Our method is divided into 5 steps that we call ladder steps, ranging from the least invasive to the most invasive, as it was observed that most patients only undergo open surgery because they have a lot of pain along with the loss of quality of life; so our focus is to immediately block the pain and give conditions back to the individual's normal activities.
CTIDor method for spilled disc and back pain treatment:
Use of minimally invasive procedures in 5 steps: it starts in the least invasive, and only when it does not improve, it goes up to more invasive.
Our method is indicated for patients with a lot of pain, severe pain, disabling pain or those with so-called refractory pain, which does not respond to conservative treatments.
On this step we perform blocks guided by X-ray image, following the pattern of pain, when it
comes to pain in the spine irradiated to the legs or arms, we perform the transforaminal block, at the
level where the spilled disc clamps the nerve root; when it comes to pain on top of the spine or referred
to the sides, we block the spine joints (facets) or interlaminar epidural block. To perform any block, anesthesia is performed the skin, then we puncture with a fine needle and guide the tip of the needle through X-rays to the exact level of the spine that produces the pain. Then we inject anesthetic and if
the patient feels immediate relief, we inject the corticosteroid to fight inflammation at the site, the target
of pain. With image-guided blocks, pain relief is achieved by 90% of patients. Only in those patients
in which the pain does not improve or in which the pain back after a while is that they
go up for treatment with the next step.
In this step, we carry out the procedures with radio frequency, which are performed
with local anesthesia, we perform the needle puncture and place the electrode by
inside the needle, then we connect the electrode with a cable to a device that
transmits radiofrequency energy to the tip of the needle when we turn on the
device for 90 seconds produces a nerve injury that is close to the tip of the
needle leading to pain relief; with this technique we can do: 1- Rhizotomy
radiofrequency - is the damage to the nerves that lead to facet pain, which are
the small joints of the spine, which wear out, inflame and cause pain.
2-Nucleoplasty - is the lesion of the disk nucleus, thereby promoting the reduction of
disc, hernia and pain relief. 3- Anuloplasty - is an injury to the nerves inside the
disc, promotes relief of discogenic pain. 4- Ganglion ablation - promotes
blocking pain conduction. In those patients where the pain does not improve or
when the pain comes back after some time, they go up to the next step.
In this we perform percutaneous surgeries in which we remove by means of punctures with small cannulas, pieces of the disc and hernia to decompress the clamping of the nerve root, they are also done with local anesthesia. With this technique we can do: Mechanical discectomy, automated discectomy, laser discectomy (PLDD) or DISC-FX. In those patients where the pain does not improve or where the pain returns after some time, they go up to the next step.
In this we perform endoscopic surgeries, they are done by placing thin tubes of 6 to 12mm in diameter in the column at the level of pain, through an optical microfiber of the barrel the image of the tip inside the column is transmitted to a TV, as well as a view of the endoscopy we remove the pieces of the herniated disc with instruments, this ends with the clamping of the nerve root, they are also done with local or epidural anesthesia, with this technique we can do: Mechanical discectomy, hernia removal, spinal canal decompression, foramen decompression and Epiduroscopy. So only that patient in which the pain does not improve after all minimally invasive procedures, who still suffers from the intense pain that causes him disability, difficulty in living, loss of strength or movement, do we recommend arthrodesis open surgery, with that only very few patients go up
to the bottom step.
FIFTH STEP :
On this step, open surgery or conventional surgery is performed: it is a major surgery, performed under general anesthesia, in which the opening of the column from the skin to the bone is made, opening of the vertebral canal for decompression, replacement of the discs with spacers, with the placement of screws and fixation of the column by metal rods. Those patients who cannot undergo open surgery are treated with the placement of permanent implants: implantation of an electrostimulation system or a morphine infusion pump; some refractory patients may also benefit from ozone therapy, which is a type of treatment done with the injection of ozone into the disc or epidural, as the case may be; this procedure must be done guided by X-ray image to have a good result.