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herniated disc

Nucleoplasty

Nucleoplasty is a minimally invasive surgical procedure also commonly called percutaneous discectomy. The technique is used in many patients who have not responded to more conservative therapy options and are frightened by the idea of fully open herniated disc surgery (a very justifiable feeling…)

nucleoplasty

What is Nucleoplasty?

This surgery is very similar to the time tested IDET procedure, but represents a significant improvement over that older surgical technique. The operation is performed as an outpatient procedure and typically takes about a half hour to complete. During the procedure, the doctor makes a small incision and places a tiny catheter directly into the affected herniated disc. The surgeon then places a small radio transmitter into the disc and treats the nucleus pulposus with specialized radio waves which break up the nucleus material. Just enough nucleus material is destroyed to alleviate the pressure on the outer disc wall, allowing the herniation to shrink and the disc to return to normal asymptomatic size. After the correct size is achieved, the catheter is removed and the wound is covered. Patients can leave the operating facility immediately and do not usually suffer any significant discomfort from the surgery.

Procedural Indications

This particular procedure is only indicated for bulging discs, not ruptured discs. It is crucial that the outer disc wall remains intact in order for the technique to be effective. Correct diagnosis of the disc condition is vital and any annular tears must be ruled out if the surgery is going to be considered appropriate treatment. While this operation can relieve symptoms in some patients, it is still a surgical technique. Therefore, it should be considered only as a last resort when all other noninvasive modalities have failed.

Nucleoplasty Advice

I am not an advocate of using surgery to correct herniated discs for a number of reasons. First, surgery is rarely needed, since most disc pain conditions will resolve themselves. When a disc is blamed for chronic back pain, the diagnosis is often incorrect and surgery will have no hope of relieving the pain, unless exclusively due to the placebo effect.

Even when a disc is the actual cause of ongoing pain, non-surgical spinal decompression is often a far better option and even offers better curative results. However, all this being said, the percutaneous discectomy technique is generally well tolerated, moderately effective and does not produce significant risk for spinal tissue damage. If you had to choose a particular surgical solution for chronic disc pain, this would be a good contender.

Nucleoplasty to Herniated Disc Home
9/14/09


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