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Nucleoplasty is a procedure name used to describe a disc decompression performed using Coblation® technology to ablate and remove tissue in the nucleus pulposus of the disc. Because tissue removal is achieved at temperatures of approximately 40-70ºC, thermal damage to surrounding tissue is minimized. Coblation technology has been used in over 4.5 million procedures worldwide.
Am I a candidate for disc nucleoplasty?
If you have back or leg pain from a contained disc herniation or protrusion that does not respond to less invasive or more conservative therapies, you might benefit from a nucleoplasty procedure. Most back or leg pain from a contained disc herniation or protrusion gets better on its own in the first month or two, so typically physicians do not consider nucleoplasty until at least a month after the onset of back or leg pain. Also, if your back or leg pain is not severe enough to limit your activities, you probably should not have nucleoplasty.
How do I know if my back or leg pain is from a damaged disc?
The wall of the spinal discs can get cracks or fissures as we age, and the discs can degenerate naturally. This is known as internal disc disruption or degenerative disc disease. Disc degeneration, bulging or protrusion can also come from an injury. If the wall is damaged or weakened, the disc might develop a very prominent bulge that we often call a herniated disc. When the disc causes back pain, the pain is usually felt as a deep, aching pain in the back and sometimes in the buttocks and into the thigh. When the disc causes leg pain, the pain is usually felt as a sharp, electric, stinging pain in the buttocks and into the thigh, calf or foot. This leg pain is called radicular or nerve root pain and is commonly referred to as sciatica by many patients. Not all back or leg pain comes from disc damage. MRIs and other studies of the discs can often help to predict if the pain is from a damaged disc.
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.
If The Disc Nucleoplasty Does Not Work, Will It Cause A Problem If I Then Need An Open Spine Surgery?
No. If the nucleoplasty is not effective, there will be no problem if the patient decides or ultimately requires an open spine surgery. The nucleoplasty does not damage or alter the tissue around the spine, nor does it change the internal spine anatomy except for the expected and desired changes inside the disc itself.
If I Have Had Previous Spine Surgery, Can I Still Have A Disc Nucleoplasty?
Maybe. If there has been previous spinal fusion at the level of concern, it will be difficult, if not impossible, to perform a nucleoplasty. If the disc in question is outside the area of previous spine surgery, it is quite possible that a nucleoplasty can be performed.
Who Should Not Have A Disc Nucleoplasty?
If you are on a blood thinning medication, if you have an active infection, or if you have poorly controlled diabetes or heart disease, you should not have the procedure. Also, if you have a large extruded disc without an intact disc wall or disc rim, nucleoplasty may not be helpful.
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Nucleoplasty is a procedure name used to describe a disc decompression performed using Coblation® technology to ablate and remove tissue in the nucleus pulposus of the disc. Because tissue removal is achieved at temperatures of approximately 40-70ºC, thermal damage to surrounding tissue is minimized. Coblation technology has been used in over 4.5 million procedures worldwide.
