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Nucleoplasty / Percutaneous Decompression

 

What is Nucleoplasty?

 

Nucleoplasty is a minimally invasive procedure in which small amounts of disc tissue are removed to allow for decompression, and the area around them treated thermally.

 

What should I expect from the procedure?

 

The nucleoplasty technique is percutaneous and does not require any incision. It is most useful in patients with nerve root irritation due to smaller disc bulges or contained ruptures.

Nucleoplasty is usually performed on an outpatient basis. Local anesthesia and mild sedation may be used to reduce discomfort during the procedure. Nucleoplasty patients will be awake to provide important feedback to the physician.

 

With the guidance of x-ray images, the physician first advances a needle into the disc. A specialized device known as a SpineWand™, will then be introduced through the needle into the disc. Therapy consists of creating a series of channels in your disc and then thermally treating the tissue immediately adjacent to the wand. The nucleoplasty process usually takes approximately one hour.

 

Does the procedure hurt?

 

You may feel a sense of pressure, or mild discomfort when the needle is inserted into the disc. The ablation is relatively painless otherwise. Your physician will closely monitor your comfort level during the entire procedure and provide medication as needed.

 

Will I know right away if the procedure worked?

 

Most patients experience improvement in leg symptoms faster than back symptoms. It may take several weeks before the final results are known.

 

Who may benefit from nucleoplasty therapy?

 

Patients with contained disc herniations may benefit from this therapy. Nucleoplasty is a minimally invasive procedure developed for these patients, combining disc decompression with thermal treatment.

 

Can I eat on the day of the procedure?

 

No, you should not eat the day of your procedure. Small amounts of clear liquids are permitted. You should also arrange to have someone drive you home.

 

What should I expect after the procedure?

 

We advise patients to take it easy the day of the procedure. You may need to apply ice to the affected area for 20-30 minutes at a time for the next 48 hours. Your doctor will provide specific activity restrictions if indicated. Typically lengthy driving, lifting, bending/twisting at the waist are restricted in the first few weeks. Formal physical therapy may begin at 2-4 weeks post-procedure.

 

Are there any potential risks to the procedure?

 

Generally speaking, this procedure is safe, however with any procedure there are associated risks, side effects, and complications. The most common side effect is temporary discomfort following the procedure. Other risks include damaging local nerves, infection, bleeding, and worsening of symptoms. Fortunately, because the procedure is performed with x-ray guidance in a controlled environment, serious side effects and complications are rare.

 

Adapted from http://www.neurosurgery.pitt.edu