There was a discussion on Braintalk about Dr. Hoogland's abrasion procedure and the potential for restoring disc height. Since I was at the AlphaKlinik, I tried to get some information to enhance the discussion. Here is what I just posted on
this braintalk thread.
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Several days ago, I returned from 3 weeks in Europe. I had a series of clients having surgery at the AlphaKlinik and also spent 4 days in Holland with another client for a MAJOR spinal reconstruction (after a series of botched fusions left the patient permanently stooped over with an L4-5 fused at a terrible angle.)
When I saw this discussion, I took the opportunity to learn more about Dr. Hoogland's abrasion procedure. I've attended several surgeons' conferences on minimally invasive spine surgery where I discovered that Dr. Hoogland is considered one of the 3 or 4 'fathers' of modern endoscopic spine surgery. I got to spend a day in the OR with him... asking a thousand questions during the surgeries... asking a thousand more between surgeries as he explained more using spine models, surgical instruments and the patients' films. On days like these. I have to pinch myself... I can't believe that I get to do what I do for a living.
In any case, it was incredible to watch him work. I've seen many different endoscopic surgeons work and there is a huge difference from one to the next. Dr. Hoogland was always very sure and accurate, able to place the instruments exactly where he wanted them. No backing up and resetting over and over. This takes a great deal of skill, practice and ability to think in 3-D. There was never any fumbling around.... just sure, accurate, efficient treatment.
In cases with one-sided herniations, the patient is on his side, which is the most comfortable. When herniations exist on both sides, the patient lays face-down and a separate procedure is done for each side. Like other endoscopic procedures I've seen, the patient is awake and is providing pain responses. (One of the most incredible things I've ever seen was when a surgeon removed a big chunk of disc material and at the same time, the patient said, "oh my god, the leg pain just went away!")
We compared and contrasted Dr. Yeung's 'inside out' technique to what Hoogland does. Both recognize the need to remove any 'interpositional disc tissue' that may be trapped in the annular tear, to increase the chance of success. Hoogland does not do thermal annuloplasty as he believes that it damages too much tissue and does not have the desired effect.
Later that day, I met with Dr. Hoogland's research assistant who provided me with a couple of abstracts and a powerpoint presentation about his procedures.
I don't know the dates or where the studies were published, but I'll find out and let you know.
Abstract: Endoscopic Transforaminal Discoplasty
Abstract: Percutaneous Endoscopic Transforaminal Disc Abrasion
Presentation: Alpha Klinik, Munich, Germany. Spinal Procedures 1990-2002
None of this addresses the original question about restoring disc height. Questions were asked about Dr. Hoogland's procedures and this is the data that I was able to get on short notice. I hope this is helpful.
Mark