Nucleoplasty is a means of reducing the production of breakdown products within the disc which may be irritant when the percolates (ooze) through the disc wall and on to adjacent structures such as the Posterior Longitudinal Ligament or nearby nerves. The technique utilises "cool" radiofrequency to interupt the production of these products and to gradually effect a reduction in a disc wall bulge. The techniques is performed by a posterolateral approach woith the patient in the aware state with all the diagnostic and safety benefits that accrue to its use and are reviewed on this site.
It is used for soft broad based bulges of the disc where the disc is in an early stage of degeneration. It may be used to compliment an Endoscopic Decompression and Foraminoplasty at an adjacent level or as a primary procedure in early stage degeneration.
Who is a Candidate for Nucleoplasty?
The best candidate for this procedure is one who suffers from a contained disc herniation that has not responded to conservative care. Typical signs of a contained disc herniation are primary pain radiating down the leg or arm accompanied by some back pain. Nucleoplasty is not useful for degenerative disc disease or spinal fractures.
Nucleoplasty has been shown to:
- Successfully decompress the spinal disc1
- Reduce VAS pain scores2
- Eliminate narcotic usage in 79% of patients2
1 Chen Y, Lee SH, Chen D Intradiscal Pressure Study of Disc Decompression with Nucleoplasty in Human Cadavers. SPINE, Vol 28, No 7. April 2003. pp 661-665.
2 Sharps L, Isaac Z Percutaneous Disc Decompression Using Nucleoplasty. Pain Physician, Vol 5, No 2. Spring 2002. pp 121-126.
An overview is shown in this pdf file on Nucleoplasty.
The technique is performed in the BMI Hospital Huddersfield or in the Clinique Toulouse Lautrec in Albi.
Benefits of Nucleoplasty:
Minimally invasive; performed using x-ray guidance
Elimination of general anesthesia
Elimination of complications that may result from open surgery
No overnight hospitalization required
Lasts from 1-2 hours
Rapid recovery time
Patients go home the same day of treatment
Quick symptom relief within two weeks for most patients
Treating Contained Disc Herniations
Historically, patients with contained disc herniations have been treated with conservative care including rest, medications, injections, and/or physical therapy. Some patients move on to surgery which can require weeks or months to recover. These treatments may result in long recovery times and major disruption of daily life. Nucleoplasty is an option for those people that have failed conservative care, and are not yet ready for major surgery.
Nucleoplasty is a minimally invasive procedure that allows the patient to go home the day of the procedure with only a small bandage on their back. The procedure is performed by specialties including pain management, physiatry, interventional radiology, and surgeons using x-ray guidance to accurately place a needle in the disc, much like an epidural steroid injection. A patented plasma device is then inserted through the needle into the disc, where excess tissue is removed. Similar to letting air out of a bicycle tire, removing some of the tissue from the center of a disc causes a reduction in disc pressure, which in turn, eases symptoms.