Nucleoplasty for slipped disc

What is a nucleoplasty procedure?

Nucleoplasty is a minimally invasive procedure done by a pain specialist to treat disc bulges and herniations. It aims to reduce the pressure within the disc so that the pressure caused by a slipped disc on the nerve root or the spinal cord is less. In selected patients, this will help them to have good and effective pain relief without needing open surgery.

nucleoplasty for slipped disc by a pain specialist, biacuplasty
Avanos biacuplasty

How is nucleoplasty performed?

The procedure is done under sedation rather than general anaesthesia, thus reducing the risks involved. A local anaesthetic injection is given to the skin when the patient is asleep, and a specialised needle is placed into the disc under X-ray guidance. Using either laser or plasma energy (depending on the device used), the disc material within the disc is vapourised. This creates a vacuum suction effect which may cause the herniated disc material to be “sucked” back in.

Pressure on the nerves and spinal cord is reduced, which leads to improvement in sciatica and neck/back pain. Nucleoplasty also deactivates the pain receptors in the disc. The procedure is done as day surgery and it is very safe with a very low risk of complications.

Who benefits from a nucleoplasty procedure?

Patients with neck or back pain with or without shooting pain down the arm or legs. MRI findings should show disc herniation or disc bulges with compression of the spinal cord or the nerve roots.

How effective is the procedure and how long can it last?

The procedure can be very effective in alleviating pain and suffering. The pain relief can be permanent and can last for many years if a herniated disc or a disc bulge is the cause of their pain. In some patients, there can be normal ageing with wear and tear. The disc can then bulge out again at the same level or at other levels at which point another nucleoplasty procedure may be needed. Pain can also arise because of other causes other than the disc, including the facet joints and the back muscles.

Is a nucleoplasty procedure safe?

Nucleoplasty is very safe, with no risk of paralysis if done by an expert. There is a very low risk (<1%) of bleeding, infection and nerve damage as it is done under X-ray guidance. It is safer than open surgery as it does not involve cutting body tissues or general anaesthesia.

How long will it be before I am back to my normal activities?

Nucleoplasty is commonly performed as day surgery which means that many people can go back to work the next day if they wish to do so. Most commonly, however, you will be given hospitalisation leave for about two weeks to recover at home. You will be guided to engage in exercises to build up muscle strength to offload the disc and spine.

After the procedure, you may feel soreness which usually resolves over the next 2 weeks The pain relief from your usual pain can be immediate or gradually improve over the next 2-3 weeks.

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