Nucleoplasty (Percutaneous Disc Decompression)

What is Nucleoplasty?

Nucleoplasty is a minimally invasive procedure for percutaneous disc decompression that uses radiofrequency based technology to ablate and coagulate soft tissue to decompress contained herniated discs. This causes the disc herniation to reabsorb, taking pressure off the exiting spinal nerves.

Why do I need a Nucleoplasty?

This procedure is reserved for patients who have not responded to medications and conservative treatments, such as physical therapy and epidural injections. The nucleoplasty is a type of procedure that can help resolve your symptoms by decompressing your disc herniation, and possibly help avoid surgery.

What is the typical procedure?

Once your provider determines you are a candidate for a nucleoplasty, an appointment will be made for you in an outpatient surgery center. You are generally given an intravenous medication to help you relax for the procedure. You will be watched closely with an EKG monitor, blood pressure cuff and blood oxygen monitoring device. You will not be asleep during the procedure. A local anesthetic will then be injected into the skin in the area that is being examined. A needle is inserted in the skin and into the disc under fluoroscopy (X-ray). A specialized device will then be introduced through the needle and into the disc. The device is then advanced and withdrawn to its original position, creating a series of small channels. The device and needle are then removed and a small dressing is placed at the injection site.

Is this procedure effective?

Yes, the nucleoplasty procedure appears to be reasonable and safe for selected patients with leg and/or back pain, with a 50% to 80% chance for significant ongoing pain relief.

What will I feel during the procedure?

You may feel minimal low back discomfort. During the actual decompression (heating), you may have a very mild reproduction of your usual back and leg pain.

How long does the procedure take?

Treating one disc typically takes 30 minutes, and 2 discs take about 60 minutes.

What are the alternatives to Nucleoplasty?

If you have back and leg (radicular) pain, the alternative treatments are medications, physical therapy, and epidural steroid injections. Your provider is most likely ordering a nucleoplasty because more conservative therapies have failed. You also have the option of surgical intervention.

What are the risks of Nucleoplasty?

As with any procedure, there are some inherent risks, although most of these are minimal. Common risks include but are not limited to bruising, bleeding, headaches, irritation of a nerve or nerve injury, including paralysis, numbness and weakness. Other risks also include infection or reactions to the medications which may cause breathing difficulties and cardiac difficulties which may lead to death. An infection could require the use of antibiotics and/or surgery. Serious risks and complications are extremely rare, however.

Additionally, if the heating element of the catheter comes too close to a nerve root or is placed in the wrong spot, this could cause damage to a portion of the spinal cord. Because of this risk, the procedure is done under fluoroscopic guidance to ensure proper placement prior to and during the procedure. In addition, you are kept awake enough to respond and let us know what you are feeling.

The Arthrocare® Spine Website includes additional information and video.

 

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Our Patients

Dr. Wolff, I just wanted to take a few minutes to thank you and your staff for what may be a very routine procedure for you, but for me it is something that has given me the ability to recapture my life. Before coming to your office, I had previously had three operations and numerous injections on my lower back. I was in constant and chronic pain and been out of work for the last eight months due to taking fairly large amounts of medication daily. I was angry at the world, my doctors and my place of employment. I did not know if I would ever be able to return to my career of law enforcement of fourteen years. I sat in my home, wanting to do things with my four boys and my wife, but knowing that I would not be able to enjoy myself due to the excruciating pain that was just a part of my life. So I sat in my chair, watching the world go by, becoming more depressed every day. When I came to your office on the very first day of my evaluation, I was met by possibly the kindest medical staff I have ever had the privilege to meet. They were professional yet understanding. I was listened to and felt like I mattered. After my final treatment, the very next day I felt such a difference in the level of pain that it was unbelievable! I didn't dare believe that this could be a lasting treatment as so many in the past would work for a week or two at the most. When I flew home to Florida, and after two weeks had passed, I woke up on a Saturday morning and I looked at my wife as we were getting ready to go somewhere, and I began to cry. She asked what was wrong and I said to her "it's like waking up from a ten year nightmare" I just couldn't believe that I was still one hundred percent pain free. It has been over a month now since you and your staff performed what I deem a miracle for me. I am still pain free, I am back to my duties as detective with the sheriff's department, I am enjoying watching my youngest sons football practices, and am spending more quality time with my wife. I am not a religious man normally; I have seen things that make one question such a thing. But I do thank God for you and what you have give back to me sir. I can never repay what you have given me, but thank you so much. David P. P.S. I'm going to enjoy the  gator hunt.
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Did You Know?

Approximately 75% of people with back and leg pain recover with conservative (nonsurgical) treatment.