Nucleoplasty



Nucleoplasty


Lubdha M. Shah, MD





Key Facts


Terminology



  • Method of percutaneous disc decompression using Coblation technology: Bipolar radiofrequency energy


  • Radiofrequency energy dissolves portion of nucleus


  • Advantage: Controlled and highly localized ablation resulting in minimal therapy damage to surrounding tissue


Pre-Procedure



  • Radicular/axial pain in lumbar spine



    • MR evidence of contained herniated disc protrusion


    • Failure of 6 weeks of conservative therapy


    • Unilateral radiculopathy or generalized cervical pain derived from contained herniated discs


Contraindications



  • Large, noncontained disc herniation, sequestration, or extrusion


  • Severe degenerative disc with > 33% loss of disc height


  • Equivocal results of provocative and analgesic discogram


  • Infection, tumor, fracture


  • Cauda equina syndrome or newly developed signs of neurological deficit


  • Uncontrolled coagulopathy and bleeding disorders


Complications



  • Nerve or cord injury


  • Vascular injury







Axial graphic shows a probe removing a portion of the nucleus pulposus image. There is a focal contained left foraminal disc protrusion impinging upon the exiting nerve image.






A wand-like device inserted through the needle and into the disc image uses heat to remove disc material and seal the channel made by the needle. The needle should not transgress the transpedicular line.


TERMINOLOGY


Definitions

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Sep 22, 2016 | Posted by in EMERGENCY RADIOLOGY | Comments Off on Nucleoplasty

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