Open spine surgery for cases of symptomatic disc herniation producing persistent back and leg pain that is intractable to conservative therapy,
may be followed by significant morbidity.
poor results have been reported for contained disc herniations with open surgical interventions.
Percutaneous treatments (table 1) in the therapy of discogenic low back pain and sciatica are used to reduce the intradiscal pressure in the nucleus thus reducing the irritation of the nerve root and the pain receptors in the annulus and the peridiscal space.
Methods and Materials
Thirteen patients (9 men and 4 women) with low back and leg pain underwent nucleoplasty in our department during the last 18 months,
after failure of conservative therapy for at least 6 weeks.
All patients had MRI proven small to medium size disc protrusion/herniation with preserved disk height of at least 50% (Fig 1).
The coblation bipolar device (SpineWand,
USA) was introduced in the nucleus pulposus through a 17 Gauge Trocar (Crawford ,
Arthrocare), positioned parallel to and at midway between the two...
Nucleoplasty was performed successfully in all cases,
on an outpatient basis.
All patients were monitored post-procedurally for 12 hours and then discharged with instructions not to perform lifting,
bending or stooping.
One week after the procedure,
patients were permitted to return to light work while nonsteroidal anti-inflammatory drugs and muscle relaxants were prescribed.
There were no complications associated with the procedure during follow-up period except from two patients reporting soreness at the needle insertion site,
which resolved within 10 days.
Significant amelioration of symptoms was...
Percutaneous nucleoplasty is a minimally invasive disc ablative technique with satisfactory clinical outcomes and low rate of complications for the treatment of discogenic low back pain and sciatica in a selected patient cohort.
The small volumetric reduction of the nucleus pulposus after the application of radiofrequency energy results in a disproportionate decrease in pressure,
hence relieving some of the chemical and mechanical factors causing pain.
The efficacy of coblation nucleoplasty for protrusion of lumbar intervertebral disc at a two-year follow-up.
Standards of practice: quality assurance guidelines for percutaneous treatments of intervertebral discs.
Cardiovasc Intervent Radiol.
Systematic review of percutaneous lumbar mechanical disc decompression utilizing Dekompressor.
Helm S 2nd,
A systematic review on...