Disc Nucleoplasty using radio waves

What is a disc protrusion?

The spine is composed of a series of bones called vertebra. These vertebrae are separated from each other by a cartilaginous material called a disc. The disc itself is structured in a ring-like manner, the external ring being a strong boundary enclosing the internal material. The substance inside the disc is a viscous substance that looks like gel.

A healthy disc serves as a shock absorber (just as in cars), serving in fact as a pillow providing protection from blows and shock, that arise from even the simplest of actions such as walking, jumping and running.

In instances in which the external envelope of the disc weakens, as the result of injury/damage or due to degenerative problems, the body weight can cause the internal substance to be pushed outwards, causing protrusion of the disc itself. Due to the spine’s special structure, and the unique location of the nerve traversing it, this protrusion could press on the nerve, leading to pain/pins-and-needles sensation/weakness or even numbness of the legs and back. In certain instances, the symptoms may pass with the help of conservative treatment such as rest, medicines, injections or physiotherapy.

Unfortunately, these treatments do not always help. In the past, patients who did not respond to conservative treatment had to live with the pain or think in the direction of major, complex surgery that also involves a healing and recovery period of weeks or even months.

What is disc nucleoplasty?

Disc nucleoplasty is a minimal procedure for treating a disc protrusion, enabling the patient to be discharged to his home after a few hours to one day of hospitalization, with a small bandage only on his back.

During the procedure, which is performed under local anesthesia and sedation only, a needle is introduced into the affected disc and placed exactly in position guided by x-ray imaging. After the needle is in place, an instrument is introduced via the needle, which creates radio waves, causing the disc material to break down through heating of that location to a temperature of 52 degrees. The needle creating the radio waves will be introduced into the disc several times and will create a number of channels in it. These channels will cause a reduction in the pressure within the disc, thus reducing the pressure on the nerve that is causing pain, in a manner that resembles releasing pressure from a tire. On completion of the procedure, the physician will remove the needle from the back and bandage the location where the needle was introduced.

What should you expect in the disc nucleoplasty procedure?

Before the procedure:
Examination and assessment by a physician, which in certain cases will include imaging examinations such as CT or MRI. In certain cases, discography will be required in order to locate the affected disc and to make a final determination of whether the patient is ready to have the procedure performed.

During the procedure:
Having a disc nucleoplasty performed requires you to lie on your side or on your stomach throughout the procedure, which is performed under local anesthesia and sedation. A needle will be introduced under your skin into the affected disc in the spine. The radio wave device will then be introduced via the needle, and reach the disc. There, it will be activated and will begin to create channels, thus reducing the volume of the disc. On the conclusion of the procedure, the needle will be removed, and the penetration site will be covered with a small bandage. The entire procedure takes less than one hour.

After the procedure:
The patient will be asked to remain under observation for a few hours, and will later be discharged to his home, to continue resting for one to three days. In most instances in which the pain was caused by disc protrusion, the pain will be relieved within up to two weeks.

What risks and complications are associated with the procedure?

The disc nucleoplasty procedure, just like any other invasive procedure, can be associated with risks. Risks with disc nucleoplasty are rare, but you should consult with the treating physician regarding this.