General information about herniated disc
Herniated disc is a disease that can affect patients of any age. It occurs as a result of trauma, injury or no cause is found, thus being called an idiopathic herniated disc. In a herniated disc, a rupture in the fibrous ring of the intervertebral disc allows the central portion (the so-called pulpal nucleus) to slide, causing severe and constant pain. It can lead to compression of the nerve roots, leading to impaired quality of life.
Until recently, the treatment consisted of pain medication, physical therapy and for more severe cases, surgeries were performed that required long periods of recovery. The disease itself and the treatment administered affected the quality of daily life.
Nucleoplasty is a minimally invasive procedure for the treatment of moderate herniated discs. Percutaneously, part of the intervertebral disc is dissolved, thus reducing the size of the hernia and compression on the nerves.
Nucleoplasty is an alternative to classic open surgery.
The indications for this technique are:
- mechanical low back pain
- low back pain and less radicular pain (which is felt on the path of a nerve in the lower limbs, on the face or back of the thigh, calf)
- failure of medical treatment
- disc herniation less than one-third the diameter of the spinal canal
- disc degeneration revealed on examination by magnetic resonance imaging
- conserved height of the intervertebral disc
This technique is not used in case of duct stenosis, instability, infection and during pregnancy.
How long is hospitalization?
Nucleoplasty is a procedure that lasts several hours. After the procedure, the patient will be under medical supervision for a few hours, after which he will be able to go home.
Risks of nucleoplasty
Complications are rare and are avoided through proper training and supervision. Possible complications include:
- allergic reactions to the contrast agent, including kidney failure
- reactions to anesthetic compounds
- the failure rate of the interventional method is very low (0.7%), but in this situation surgery may be necessary.
What happens during a nucleoplasty procedure
Nucleoplasty is performed in the angiography room, under sterile conditions, under local anesthesia.
The patient is placed on the table, on his side or lying on his stomach, and the nurse will disinfect the back area with iodine, after which he will cover himself with a sterile field. First, local anesthesia is performed with xylin, and then the radiologist will insert a catheter into the herniated disc. The catheter emits waves that will dissolve excess tissue, thus reducing the size of the hernia. This will allow the pressure inside the disc to drop, the disc will return to its normal position and will no longer compress the roots of the spinal nerves. Once the pressure is low, the pain felt by the patient will decrease considerably or disappear.
What happens after the procedure?
What should you do after you leave the hospital?
The intervention is effective in 70-80% of cases. The indication for percutaneous nucleoplasty is given after the clinical and imaging consultation (MRI). Not all disc herniations are suitable for nucleoplasty, in severe cases, the correct indication is surgery.