Low Back Pain and Sciatica and Nucleoplasty
Nucleoplasty is one of the newer, less-invasive surgical procedures. This procedure typically uses radio waves to treat patients with low back pain caused by a contained or mildly-herniated disc.
Effect of Nucleoplasty on Low Back Pain and Sciatica
In nucleoplasty, the surgeon inserts a wand-like transmitter into the disc while the patient is awake but lightly sedated. Guided by x-ray imaging, the surgeon sends radiofrequency pulses into the nucleus or center of the disc. The radiofrequency energy heats and shrinks the gel-like tissue, resulting in less volume and thus relieving pressure on the nerve impacted by the bulging disc. The entire procedure lasts about 30 minutes.
Bhagia SM. Slipman CW. Nirschl M. Isaac Z. El-Abd O. Sharps LS. Garvin C. Side effects and complications after percutaneous disc decompression using coblation technology. American Journal of Physical Medicine & Rehabilitation . 85(1):6-13, 2006 Jan.
Bridwell KH. Anderson PA. Boden SD. Vaccaro AR. Wang JC. What's new in spine surgery. Journal of Bone & Joint Surgery - American Volume. 90(7):1609-19, 2008 Jul.
Cohen SP. Williams S. Kurihara C. Griffith S. Larkin TM. Nucleoplasty with or without intradiscal electrothermal therapy (IDET) as a treatment for lumbar herniated disc. Journal of Spinal Disorders & Techniques . 18 Suppl:S119-24, 2005 Feb.
Conn's Current Therapy 2001. 53rd ed. WB Saunders Company; 2001.
Pain. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.n... . Accessed October 27, 2008.
Sciatica. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00351 . Accessed October 27, 2008.
Textbook of Primary Care Medicine. 3rd ed. Mosby, Inc.; 2001.
Updated Disketomy section on 6/7/2007 according to the following study, as cited by http://www.ebscohost.com/dynamed/what.php : Peul WC, van Houwelingen HC, van den Hout WB, et al. Surgery versus prolonged conservative treatment for sciatica. N Engl J Med. 2007;356:2245-2256.
Weinstein JN, Tosteson TD, Lurie JD, et al. Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes Research Trial (SPORT): a randomized trial. JAMA . 2006;296:2441–50.
Weinstein JN, Lurie JD, Tosteson TD, et al. Surgical vs nonoperative treatment for lumbar disk herniation: the Spine Patient Outcomes Research Trial (SPORT) observational cohort. JAMA . 2006;296:2451–9.
Zindrick MR. Tzermiadianos MN. Voronov LI. Lorenz M. Hadjipavlou A. An evidence-based medicine approach in determining factors that may affect outcome in lumbar total disc replacement. Spine . 33(11):1262-9, 2008 May 15.