Nucleoplasty

Nucleoplasty is a minimally invasive procedure where a catheter is percutaneously inserted into the intervertebral disc under fluoroscopy. It works by decompressing the nucleus of the disc. Similar to letting air out of a tire, removing tissue from the center of a disc causes a reduction of pressure within the disc. This in turn leads to a reduction in the pressure that the disc applies to other parts of the body, such as nerve roots or the spinal cord.The nucleoplasty is percutaneous and does not require any incision

Indication-

• It is most useful in patients with nerve root irritation due to smaller disc bulges or contained ruptures.
• The indications include discogenic low-back pain due to disc degeneration, as well as the treatment of lumbar disc bulges or disc  ruptures causing radiculopathy

Contraindication-

It is contraindicated in patients with complete disc  space collapse leading to inaccessibility of the intervertebral space, active disc space infection, and medical conditions that would preclude its safe performance.

Procedure of Nucleoplasty

Nucleoplasty is usually performed on an outpatient basis. Local anesthesia and mild sedation may be used to reduce discomfort  and anxiety.

Under fluoroscopy, a needle is advanced into disc. A specialized catheter is then be introduced through the needle into the disc  and positioned where the ablation is desired. The catheter has a low-temperature resister at its tip which  generates a plasma field. this plasma field disintegrates disc  material into its hydrogen and oxygen constituents which escape through the needle.  The tissue ablation and thermal treatment create a series of channels within the disc , reducing the pressure from the contained disc  herniation or the nerve root and other pain generating structures.

Complications of Nucleoplasty

A relatively safe procedure, no complication has been reported till now.

Results of Nucleoplasty

Best results have been obtained  in patients with diffuse disc  protrusion and radicular pain.

The relief is reported to occur almost  immediately after the procedure.

Frequently asked question—
What happens before the procedure?

Medical evaluation includes a physical exam. Diagnostic tests such as MRI (magnetic resonance imaging), steroid injection or discography may be conducted to diagnose and locate the symptomatic disc herniation and determine if the procedure is appropriate. 

Will the procedure hurt?

Because Nucleoplasty is a minimally invasive procedure performed under local anaesthesia, there should be minimal pain. A patient may experience some discomfort or bruising where the needle was inserted. 

What happens after the procedure?

Patients are required to remain for observation for one to two hours after the procedure. Often patients are then released to rest for one to three days with limited sitting or walking. 

How long does the procedure take?

The total procedure time is generally between 15 minutes to 1 hour. 

Can my symptoms be relieved?

In most cases, symptoms caused by the herniated disc are gone or diminished within weeks.