Nucleoplasty is a type of therapy meant to help patients with spinal disc pain. A small probe is inserted into the disc that is causing the pain and small amounts of tissue are removed. The probe them emits radio waves and heat to the area which causes the pressure inside the disc to be reduced. When the pressure is reduced within the disc, the pressure around the nerves are also reduced which reduces pain. The disc also sticks out less as well. The procedure takes about 60 minutes.
Many people will try the normal treatments such as anti-inflammatory drugs like ibuprofen. They will also try physical therapy. Some will even try epidurals to try to reduce the inflammation around the bulging disc. If these are not successful, it might be time to try nucleoplasty.
Not all discs can be treated with nucleoplasty. If the spine is out of alignment or not stable, nucleoplasty is not advised. If the rim or annulus is not intact, most of the disc material will have already been expelled from the disc so nucleoplasty won’t help. Neck discs cannot be treated with this procedure either. Only spinal discs in the back can be treated.
You may get relief from nucleoplasty if you have leg or back pain from a disc that has not ruptured. It should also only be considered after more conservative treatments have been tried. You should not consider trying this procedure unless your pain has lasted over 2 months because most leg and back pain will subside on its own after a month or two. This is considered an invasive procedure so if you can still perform your normal duties, you probably shouldn’t get this procedure.
During the procedure, the patient will have a local anesthetic and be lightly sedated. There may be slight pain when the probe is inserted or the patient may feel some pressure. When the procedure is being done, the patient may feel some of the same pain in his back or legs that he normally feels. If this happens, the patient can be confident the probe is placed in the right place.
In the United States, the success rate for the pain to get better is about 70%. When they talk about success, they mean that the pain has been reduced by at least 50%. This is an excellent alternative to open spinal surgery.
There have been no reports of permanent injury or complications from nucleoplasty. There is risk involved for things such as infection at the site of the insertion of the probe. The disc also has a chance of becoming infected but the surgical procedure is done in a sterile environment and the risk of infection is low. There is a chance of unusual bleeding that may require surgery but it is very uncommon. The only other risk is that the procedure will not work and it may even worsen.
Dajiang, R., Zhicheng, Z., Tiansheng, S., & Fang, L. (2015). Effect of percutaneous nucleoplasty with coblation on phospholipase A2 activity in the intervertebral disks of an animal model of intervertebral disk degeneration: a randomized controlled trial. Journal Of Orthopaedic Surgery & Research, 10(1), 1-6. doi:10.1186/s13018-015-0175-y
Wullems, J. A., Halim, W., & van der Weegen, W. (2014). Review Articles: Current Evidence of Percutaneous Nucleoplasty for the Cervical Herniated Disk: A Systematic Review. Pain Practice, 14559-569. doi:10.1111/papr.12122