The majority of patients with degenerative disc problems improve without necessitating interventional procedures or spine surgery. This is an overview of the nucleoplasty for degenerative disc disease in patients dealing with back pain alone or those with back pain and radiculopathy.
Many times simply benign neglect allows the degenerative painful symptoms to get better. Other times, chiropractic treatment, physical therapy, and other aerobic exercise can improve patient symptoms.
Having back surgery for degenerative disc disease is used as a final option in individuals whose leg and back pain has been refractory to nonoperative treatments. Risks of spinal fusion surgery include epidural fibrosis, scar formation, nerve root injury, hardware failure, failure to alleviate pain, epidural fibrosis, and failed back surgery syndrome.
A number of interventional procedures have been done over the last 2 decades to treat degenerative disc and lumbar disc herniations outside of open surgical techniques.
These have included chymopapain chemonucleolysis, Intra-discal electrothermal treatment (IDET), and nucleotomy procedures. None of these has achieved unequivocal success however, and some have caused anaphylactic reactions, nerve root injury, or even cauda equina syndrome.
In 2000, the FDA approved the nucleoplasty procedure using coblation technology for percutaneous disc decompression. A piece of the nucleus (inner disc) is taken out and a radiofrequency energy is applied. This provides an excitement to the area's electrolytes. It breaks down molecular bonds, and some inner disk gets dissolved.
As long as the radiofrequency energy stays at relatively low temperatures, the theory is that the surrounding disc tissue and end-plate cartilage is unaffected. Reducing the pressure in the center of the disc theoretically relieves the chemical and mechanical factors causing pain. How much of the disc is removed with a nucleoplasty procedure? About 1 milliliter, which is about 10 to 20%.
Research has shown that new bloodflow can result after the procedure, and this could result in disc regeneration and healing.
Most studies have shown no significant complications related to nucleoplasty. There was soreness post procedure which resolved nicely and an incidence of numbness and tingling and potentially worse back pain.
Looking at all studies on nucleoplasty, the average successful outcome was 62%. There is considerable debate as to whether or not nucleoplasty works well in patients with solely axial low back pain and not a radicular component. The procedure has shown, however, that it can improve outcomes in individuals suffering from discogenic back pain either with or without a radicular component.
Many times simply benign neglect allows the degenerative painful symptoms to get better. Other times, chiropractic treatment, physical therapy, and other aerobic exercise can improve patient symptoms.
Having back surgery for degenerative disc disease is used as a final option in individuals whose leg and back pain has been refractory to nonoperative treatments. Risks of spinal fusion surgery include epidural fibrosis, scar formation, nerve root injury, hardware failure, failure to alleviate pain, epidural fibrosis, and failed back surgery syndrome.
A number of interventional procedures have been done over the last 2 decades to treat degenerative disc and lumbar disc herniations outside of open surgical techniques.
These have included chymopapain chemonucleolysis, Intra-discal electrothermal treatment (IDET), and nucleotomy procedures. None of these has achieved unequivocal success however, and some have caused anaphylactic reactions, nerve root injury, or even cauda equina syndrome.
In 2000, the FDA approved the nucleoplasty procedure using coblation technology for percutaneous disc decompression. A piece of the nucleus (inner disc) is taken out and a radiofrequency energy is applied. This provides an excitement to the area's electrolytes. It breaks down molecular bonds, and some inner disk gets dissolved.
As long as the radiofrequency energy stays at relatively low temperatures, the theory is that the surrounding disc tissue and end-plate cartilage is unaffected. Reducing the pressure in the center of the disc theoretically relieves the chemical and mechanical factors causing pain. How much of the disc is removed with a nucleoplasty procedure? About 1 milliliter, which is about 10 to 20%.
Research has shown that new bloodflow can result after the procedure, and this could result in disc regeneration and healing.
Most studies have shown no significant complications related to nucleoplasty. There was soreness post procedure which resolved nicely and an incidence of numbness and tingling and potentially worse back pain.
Looking at all studies on nucleoplasty, the average successful outcome was 62%. There is considerable debate as to whether or not nucleoplasty works well in patients with solely axial low back pain and not a radicular component. The procedure has shown, however, that it can improve outcomes in individuals suffering from discogenic back pain either with or without a radicular component.
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