An alternative to surgical treatment for cervical and lumbar discopathy
Nucleoplasty is currently the most modern surgical procedure in the spine with percutaneous removal of a fragment of the intervertebral disc whose abnormal displacement is the cause of the pain syndrome. Nucleoplasty is a minimally invasive and very effective clinical procedure. Another important advantage of the procedure is that the patient is free to go home soon after the procedure.
Indications for nucleoplasty:
- small bulges of the intervertebral disc (discopathy) whose treatment by open surgery is in most cases ineffective and burdensome for the patient,
- for larger herniated intervertebral discs, the procedure is used for patients who cannot be treated with the traditional method due to general medical contraindications.
The nucleoplasty procedure involves the plasticity of the spinal disc using a special electrode that produces plasma, causing a reduction in the volume of the disc, which helps to reduce pressure on adjacent nerve structures. After the procedure, the patient’s general condition improves and unpleasant ailments related to the disease completely disappear.
Eligibility for the procedure
The eligibility for surgery is assessed by a specialist neurosurgeon and is based on the reported pain, neurological condition and the result of the NMR examination. The doctor may additionally recommend an EMG test.
Description of a nucleoplasty procedure
The procedure takes place under local anaesthesia with the patient positioned on their abdomen. The patient is given an antibiotic and mild hypnotics before the procedure. In Vratislavia Medica nucleoplasty is performed in the operating theatre under X-ray control (C-arm). As the neurosurgeon uses a posterior-lateral approach bypassing the spinal canal and nerve structures, the procedure is minimally invasive.
The intervertebral disc is punctured percutaneously using a special cannula (special surgical needle) under X-ray control. Using a cannula, an electrode is inserted which produces a plasma arc at its end, allowing the mass of the nucleus pulposus to be broken down into water molecules and carbon dioxide. The coablation process takes place at a temperature of 40-50° C. Since it only occurs at the electrode tip, the surrounding tissues are not affected and the risk of possible complications is greatly reduced. The electrode, under constant X-ray control, changes its position in 6 directions, thanks to which the volume of the nucleus pulposus is reduced by 10-20%, which is sufficient to significantly reduce the pressure inside the disc and the withdrawal of the hernia.
Good and very good treatment results are obtained in more than 80% of patients. It is important to bear in mind that nucleoplasty is not a miracle cure; after the procedure, the disc does not return to its pre-disease state, but the pressure on the adjacent nerve structures is reduced, thus relieving the complaints. In order for this condition to last for a very long time, it is important to lead a healthy lifestyle and to follow the recommendations of your doctor.
Duration of procedure:
ca. 1 -1.5 h
Duration of hospitalisation:
the procedure is performed as a one-day surgery, the patient can go home about 1 hour after the procedure.
4-6 weeks to complete healing of the disc.
recommended depending on the patient’s condition.