About Contained Disc Herniations
The spine is composed of bones called the vertebrae. Each of these bones is connected by a disc, made of a tough outer layer called the annulus, and a gel-like center called the nucleus pulposus. A healthy disc is like the shock absorber of an automobile, providing a cushion against jolts caused by a simple movements like running or jumping.
If the protective shell of the disc is damaged by injury or weakened by age, a portion of the shell can give way to pressure causing the gel-like nucleus to either bulge or leak out. This is also called a herniated or slipped disc.
Treating Contained Disc Herniations
Historically, patients with contained disc herniations have been treated with conservative care including rest, medications, injections and/or physical therapy. Unfortunately, this does not always provide relief. In the past, people who did not respond to conservative care were forced to live with the symptoms or consider major surgery. If they underwent more invasive surgery, it could take weeks or months to recover, causing a major disruption in their daily lives. With nucleoplasty, there is minimally invasive alternative to major surgery that allows the patient to potentially go home the same day of the procedure.
Nucleoplasty is performed using x-ray guidance to accurately place a cannula (small tube) into the disc. A patented SpineWand device is then inserted through the cannula into the center of the disc using Coblation technology to remove excess tissue. As a result, the disc pressure is reduced, which eases symptoms.
What to Expect
Before the Procedure
Medical evaluation includes a physical exam. Diagnostic tests, such as MRI (magnetic resonance imaging), steroid injection, or discography may be conducted to diagnose and locate the symptomatic disc herniation and determine if the procedure is appropriate.
During the Lower Back Procedure
Nucleoplasty requires the patient to lie on their stomach throughout the one hour procedure. This is typically performed minimal anaesthesia requirements. A small incision is made in the skin near the spine, and a cannula is inserted into the disc space. The electrosurgical decompression device, is then inserted through the cannula into the disc and activated to remove the nucleus tissue. The device and cannula are removed and the small incision is dressed with a surgical bandage.
After the Procedure
Patients are required to remain for observation for one to two hours after the procedure. Typically, patients are then discharged and asked to rest for one to three days with limited sitting or walking. In most cases, symptoms causing by the disc herniation are gone or diminished within weeks. A patient may experience some discomfort or bruising where the cannula was inserted. After about one week, patients participate in physical therapy which is important for a full recovery. They are typically allowed to engage in some physical activity and return to work. Your doctor will map out a comprehensive recovery schedule.
Who is a Candidate for Nucleoplasty Procedure?
The procedure is used to ablate and decompress disc material to treat symptomatic patients with contained herniated discs.
Benefits of Nucleoplasty Procedure
- Minimally invasive; performed using x-ray guidance
- General anaesthesia is not necessary
- Minimisation of complications that may result from open surgery
- Outpatient procedure
- No overnight hospitalisation required
- Lasts from 1-2 hours
- Rapid recovery time
- Patients may go home the same day of treatment