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Old 03-30-2007, 03:16 AM
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mmglobal mmglobal is offline
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Readers under 18 or with a weak stomach should change the channel now. The images we are about to describe may be quite disturbing.

Remember that these are my 'layperson impressions' and what I perceive may be completely incorrect.

I'm very sorry, but the crab meat analogy is very valid. (I did serve crab salad at one of my GPN gatherings, but I don't think Dale was there. Good thing!)

I've only seen a few relatively healthy discs removed. They were in the middle of long constructs with some evidence of degeneration or instability, that made it unreasonable to leave them out of the surgical plan. The difference in appearance of the nucleus material is remarkable. Very white... very fluffy, very moist. (Jokes about balsamic dressing deleted.) In general... just very healthy looking... good structure...

The more and more degenerated... the more those qualities are gone. What was bright white is now dingy looking... cream colored or yellowed. What was fluffy and moist is now stringy, tough and dehydrated. The worse the disc, the stringer and tougher the nucleus material seems.

Discs that have been IDET'ed or Thermal Annuloplastied have appeared to be BBQ'ed. Some of the nucleus and annulus tissue has been cooked. The tissue is much darker... even brown. Fluid from the disc has appeared brown. I've seen one disc that had both treatments and it was the most cooked of all I've seen. (Note that I make no assumptions about the performance of the tissue. It may be that a successful procedure will address pain generators and there is no lasting effect of the bbq'ed tissue. I'm just noting the appearance of tissues I've seen.)

The disc that had the 'disc sealant' was in a relatively young man and not too severely degenerated. The structure of the nucleus material was different from any other disc I'd seen. It was mushy. It had no integrity. It was very moist... possibly some injectant still inside the disc? I don't know, but the appearance of healthy disc tissue was completely gone. (I don't know how this effects the performance of the tissue... I'm just noting that it appeared to be very unlike normal tissue.)
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1997 MVA
2000 L4-5 Microdiscectomy/laminotomy
2001 L5-S1 Micro-d/lami
2002 L4-S1 Charite' ADR - SUCCESS!
2009 C3-C4, C5-C6-C7, T1-T2 ProDisc-C Nova
Summer 2009, more bad thoracic discs!
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