written by Bogdan Cristian Dorobat-Primary Care Cardiologist and Interventional Radiology
Herniated disc is a very common condition that causes major problems, especially for young, active people.
Until now, drug treatment, bed rest, physiotherapy and finally surgery were the only therapeutic alternatives.
Interventional radiology allows the effective treatment of a herniated disc by a minimally invasive method called Percutaneous Nucleoplasty.
About the intervention
The intervention lasts 15-20 minutes, and the patient is discharged after 3 hours. The recovery period is several days.
Not every disc herniation has an indication for nucleoplasty (there are certain conditions such as: the patient’s age should not generally exceed 50 years, the intervertebral disc should not contain free fragments migrated into the spinal canal and should not show symptoms of neurological deficit such as paresis.
The treatment is personalized and the well-established indication plays an important role in the success of the procedure – which is why it is very important for the doctor to make an evaluation and decide whether to recommend nucleoplasty or classic intervention.
The success rate of the procedure is 75-80%. The failure of the procedure does not lead to the aggravation of the patient’s condition, remaining the alternative of a „classic” intervention.
What is the intervention?
The operation consists of puncturing the intervertebral disc and removing part of the nucleus pulposus (a gelatinous material in the middle of the intervertebral disc). This reduces the pressure in the disc wall.
The disc returns to its normal position and no longer compresses the roots of the spinal nerves. Decompression of the spinal nerves leads to a decrease or even disappearance of symptoms. The intervention is effective in over 80% of cases.
The nucleoplasty takes place in the angiography room, the patient being in a supine position, lying on his stomach.
If the displacement of the disc is very large or if its wall is broken, surgery remains the only therapeutic option.
When is Nucleoplasty Recommended?
Percutaneous nucleoplasty is indicated for patients with lumbar disc herniations (one or more, maximum 3 hernias) in whom conservative treatment (drug and physiotherapy) did not work and in whom surgery is not mandatory (unless there is severe root damage nervous) with severe neurological deficit.
- mechanical low back pain
- low back pain
- disc herniation less than one-third the diameter of the spinal canal
- disc degeneration revealed on MRI examination
- conserved height of the intervertebral disc
Is nucleoplasty painful?
No, nucleoplasty is not painful. It takes place under local anesthesia, so the patient will be aware throughout the operation and will be able to report any discomfort. Light sedation is used.
The indication for nucleoplasty is established following a clinical examination and an MRI examination.
Recovery after nucleoplasty
This procedure is outpatient and takes about 30 minutes.
It is recommended not to drive the car on the day of the intervention, but from the next day normal activities can be resumed. The patient will receive anti-inflammatory and decontracting treatment after the intervention.
After a maximum of 2-3 weeks after the operation, the relief of symptoms should appear. The volume reduction of the disc takes place progressively within a few months.
The advantages of nucleoplasty
- Small incision
- Minimally invasive intervention
- Reduced muscle damage
- Associated low risks
- Hospitalization for 3-4 hours and then you can leave the medical institution
- Rapid recovery and pain relief
If you have problems with your spine, consult a specialist for the best recommendations. Within the AngioLife center, this intervention can be carried out in conditions of maximum safety and benefiting from the best specialists and modern equipment.