Nucleoplasty is a minimally invasive procedure developed
to treat patients with contained, or mildly herniated
discs. Nucleoplasty literally means removal of the
nucleus (nucleus pulposus is the center gel-like
substance of the disc.) The outer band-like substance of
the disc is the annulus fibrosis. Typically when a disc
herniates, the annulus fibrosis opens and allows the
nucleus pulposus to protrude and compress structures
such as nerves. Nucleoplasty does not involve an
incision. A special access needle is placed into the
disc under x-ray guidance. A wand-like device is then
inserted through the needle and into the disc. The
device uses heat to remove disc material and seal the
channel made by the needle. Several channels are made
depending on how much disc material needs to be removed.
procedure is performed in a surgical center with
fluoroscopic (x-ray) guidance. Nucleoplasty is done with
the patient lying on the stomach. Intravenous sedation
is given to help with comfort and relaxation. The skin
is cleaned with an antiseptic solution and the back is
numbed with a local anesthetic before the procedure is
performed. The patient is monitored with an
electrocardiogram, blood pressure cuff and blood
will I feel during the procedure?
feel a sense of pressure, or mild discomfort when the
needle is inserted into the disc. When an abnormal disc
is injected, you will feel pain. Your physician will
closely monitor your comfort level during the entire
many discs are treated?
your symptoms and your MRI, your doctor will determine
which disc(s) may be causing your pain. Typically, only
one disc is treated at a time.
does Nucleoplasty take?
Nucleoplasty takes about 30 to 45 minutes, depending on
the amount of disc material that needs to be removed.
the injections hurt?
procedure involves inserting a needle through skin and
deeper tissues, so there is some discomfort involved.
However, your doctor will numb the skin and deeper
tissues with a local anesthetic using a very thin needle
prior to inserting the needle into the disc. Most of the
patients receive intravenous sedation and pain
medication, which makes the procedure easy to tolerate.
You may have a flare-up of your back pain after the
injection, but this gets better in a day or two and can
usually be managed with ice packs and oral pain