Arthroscopic knee surgeons use shavers to remold the cartilage of the knee and try to promote conservative measures in preservation of normal function and structural integrity of the cartilage. It is interesting that recent studies have shown the annulus to be composed of cells histologically identical to knee cartilage. Also, the nuclear cells appear to be similar histologically. Removal of too much disc material leads to increasing loads on the annulus and causes biomechanical instability of the joint. Stress loading of a joint with degenerative intervertebral disc demonstrates the annulus is much more likely to continue to degenerate and that the normal annular integrity is sufficiently compromised that lateral torque, anterior, and posterior flexion of the joint is much more permissible.
Continued degeneration causes extreme stiffening of the annulus.
All this information implies a conservative approach to discectomy should be used. Some studies have shown discectomies ultimately help with limb pain but may result in long term back pain through involvement of increased stress loading of the annulus. Arthroscopic discectomies via the extrapedicular approach may advance the capabilities of the discectomy to the point arthroscopic knee surgery now enjoys. Conservative arthroscopic annuloplasty for disc degeneration may also hold hope for the future and may present a third alternative to treatments which currently consist of IDET and spinal fusion. If you want to post a completely new article on any topic you like, click here.