Intradiscal Endoscopic Nucleus Therapy with intENTS®
intENTS® Lumbar and Cervical are two intradiscal endoscopic nucleus instrument sets used for minimally-invasive treatment of nerve compressions and discogenic pain.
Access is via the Seldinger technique: The cannulated instruments are inserted via a guide wire. The therapy is carried out through a guiding tube and the nucleoscope shaft.
intENTS® is a small instrument set for minimally-invasive intradiscal treatment of disc protrusions, smaller herniated discs and discogenic pain, generally attributable to annular fissures. For this, instruments are introduced via an endoscope shaft directly into the disc.
Disc protrusion or hidden prolapse
While a disc protrusion is not a classic indication of a need to operate, the chronic complaints that are attributable to disc damage can be an indication for operating, using a percutaneous method for the procedure
Discogenic pain syndrome
Knowledge of disc-related diseases has steadily increased over the past 15 years, and it is now known that the disc itself can also be a pain trigger. Chronic deep-seated back pain, together with restricted ability to remain sitting for extended periods, are amongst the symptoms of this disease.
The causes of discogenic pain have not yet been definitively clarified. However, progressive disc degeneration and shear stresses on the disc induce small tears in the ring of fibers (annular fissures) that are capable of triggering the pain. In this context, the term “high-intensity zones” (HIZ) is also used; in MRI, these represent a visible sign of disc degeneration (a bright zone in the disc ring).
Volume reduction of the disc
The volume reduction of the disc can be carried out mechanically with the forceps contained in the instrument set, or by tissue vaporization using bipolar probes.
Volume reduction using forceps
In the instrument sets, flexible and straight forceps each are included, which are used to remove nucleus tissue. If necessary, the tissue can then be histologically investigated.
Volume reduction through bipolar probes Vaporflex® and Legato®
The two bipolar probes Vaporflex® (intENTS® Lumbar) and Legato® (intENTS® cervical) gently shrink the nucleus tissue using vaporization. During the procedure the nucleus is kept constantly moist with a rinsing system. The supply can be directly connected to the probe (Vaporflex®) or the nucleoscope shaft (Vaporflex®, Legato®).
Treatment of the dorsal annulus curvature
Using the flexible and curved tip of the probes, the dorsal annulus curvature is scanned, and any annular fissures shrunk. The nucleoscope is then used to visualize and check the result of the procedure.