Disc Nucleoplasty

Nucleoplasty is a minimally invasive treatment for contained herniated discs. In nucleoplasty, advanced radio-frequency devices are used to remove soft tissue in open and minimally invasive spinal surgery. Tissue is ablated and coagulated through molecular disintegration, with only minimal thermal damage to surrounding tissue.

In some cases, nucleoplasty is the answer to quick, lasting relief -- but without the drugs or major surgery associated with other methods, according to Arnold E. Feldman, M.D., a board certified anesthesiologist.

Dr. Feldman indicated although it is surgery, the procedure is relatively simple -- more like getting a vaccination or steroid injection. It's minimally invasive.

Directed to the precise source of the pain, the radio waves work to gently dissolve small amounts of unwanted spinal disc tissue, thus reducing the pressure in the disk. It's the pressure that can cause lower back and upper leg pain, Dr. Feldman explained.

Nucleoplasty disc decompression is considered a "conservative" approach to pain management, much on the order of pain drugs, epidural steroid injections and physical therapy, he said, as opposed to radical approaches requiring more invasive surgical techniques.

To understand what a contained herniated disc looks like, Dr. Feldman suggested one should think of a bicycle tire with a bulge in it. When a bulge or "herniation" appears in the shell of a disc, severe pain can result. This is because the disc is surrounded by sensitive nerve roots.

"When the bulge becomes large enough to come in contact with these nerve roots, the sensation of pain can radiate throughout the lower back and upper legs," Dr. Feldman said.

So, in much the same way that a bulging tire can be reduced by releasing some of the air, a herniated disc can be treated by relieving pressure inside the disc.

The procedure begins with a local anesthetic and light sedative. With the patient awake, small amounts of raidio wave energy are released into the damaged disc through a catheter-like device that is about the thickness of a dime.

"The energy creates a reaction at the molecular level that dissolves some of the spongy tissue inside the damaged disc," Dr. Feldman explained. "Then, as pressure inside the disc is reduced, the herniation in the shell retracts. Irritation to the nearby nerve roots is eliminated, and pain is relieved."

Typically, the entire nucleoplasty radio wave injection procedure takes 20 to 30 minutes, and the patient is ready to walk out of the clinic in about an hour.

According to clinical studies, the results are about the same as those of traditional disc surgeries -- but with a big difference. "With nucleoplasty, the patient does not experience the trauma, lengthy recovery period, high cost, or most other potential complications," the doctor said.

Based on these studies, he said, approximately four out of five nucleoplasty patients have seen successful results as measured by patient satisfaction scores, reduced pain, absence of narcotics use, and return to work.

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