Nucleoplasty is a percutaneus procedure where a catheter is percutaneously inserted into the intervertebral disc under fluoroscopy. The catheter has low-temperature resister probe to disintegrate and evacuate disc material causing disc decompression.
The nucleoplasty is percutaneous and does not require any incision.
Indications for Nucleoplasty
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.
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.
Please bring any previous imaging study results (MRI, CT, x-rays) such as films, reports, or CD-ROMs to your initial visit. If you do not have current images, we may refer you to have studies done prior to the procedure.
You will receive specific instructions to follow prior to the procedure with regard to eating and drinking. You will need someone to drive you home and stay with you for 12 hours post-procedure due to the effects of sedation medications. Please make any necessary arrangements. Please notify our physician if you are nursing or if there is a chance you may be pregnant.
Please be prepared to discuss any medications that you are currently on with our physician, or bring your medication bottles with you to your initial appointment.
During the Procedure
You will be awake during the procedure to provide important feedback to the physician, but you will be under a sedative to diminish your anxiety and any discomfort. After you are in position on the table, your lower back will be numbed with a local anesthetic. Under x-ray guidance (fluoroscopy), a small, tube-like needle is placed into the center of your bulged disc.
A small, specialized wand is inserted through the needle, where it is heated to create a series of channels within the disc by dissolving tissue. By reducing the amount of excess tissue within the disc, this treatment can reduce the size of the bulge and also relieve pressure inside the disc, as well as on the adjacent nerves.
The wand will then be slowly withdrawn to its original position while thermally sealing the new channel. You will be closely monitored during your procedure. The number of channels created is dependent on the disc size. At the end of the procedure, the wand and needle will be removed.
After the Procedure
A small bandage will be placed over the needle insertion site and you will be taken to the recovery area until you are ready to go home. Adult supervision is necessary for the remainder of the day due to the effects of sedation. You will receive general activity and rehabilitation guidelines. You may experience increased symptoms for 7-10 days until the disc begins to heal. Prescription medications may be given to relieve these symptoms.
Call for an Evaluation
Call our office to have one of our board certified physicians evaluate your condition. Our physicians specialize in pain management and offer many options for pain relief. Our phone number is (510) 582-8555.