Nucleoplasty Spine Surgery
Nucleoplasty is a relatively new advancement in the field of spine surgery. It is a procedure used to reduce disc pressure in patients suffering from discogenic (disc related) backache. It is a percutaneous procedure in which some of the disc material is disintegrated to relieve the intra discal pressure using a low temperature resistor. As it does not require any incision over the body, it is beneficial for patients complaining of back pain with disc pathology and unwilling to undergo full fledged discectomy.Post a Query
The intervertebral discs are soft, cushion like structures between two adjacent vertebral bones in the human spine. Their main function is shock absorption. These discs are hydrated and are made up of a central structure called the nucleus pulposus and a surrounding structure called as annulus fibrosis. But with age they lose their water content and the disc becomes hard and begins to degenerate. The wear and tear process is aggravated by faulty spine movements, faulty posture, lack of exercise, obesity etc.
The inner disc material pushes the outer annulus wall causing it bulge. This bulge can be large enough to compress the surrounding structures like the spinal cord and the spinal nerves resulting in severe back pain and radiating pain in the arm or leg. This condition can affect the cervical (neck) or lumbar (low back) region of the spine.Request a Call Back
Objective of the Procedure
Nucleoplasty aims at disintegrating some portion of the inner material of the disc to reduce the intradiscal pressure and retract the bulge. This alleviates pain as the compression of the nerves is relieved. The procedure is only successful in cases of contained disc bulge. That means the outer annulus layer of the disc should be intact. It is contraindicated in patients with complete disc space collapse leading to inaccessibility of the intervertebral space, active disc space infection, and medical conditions that would preclude its safe performance.
This is a minimally invasive procedure performed under local anesthesia and is completed within 30-45 minutes. It performed on an out patient basis and the patient is allowed to go home after the procedure on the very same day. Under fluoroscopy, a needle is advanced into the involved disc. A specialized catheter is then introduced through the needle into the disc and positioned where the ablation is desired. The catheter has a low-temperature resister at its tip which generates a plasma field. This plasma field disintegrates disc material into its hydrogen and oxygen constituents which escape through the needle. The tissue ablation and thermal treatment create a series of channels within the disc, reducing the pressure from the contained disc herniation or the nerve root and other pain generating structures. The patient is relieved immediately after the procedure.
Since this is a minimally invasive surgery, the amount of tissue damage is less and so the patient recovery is quicker. He is taught a few series of progressive, stretching, strengthening and endurance exercises by the Physical therapist on an out patient basis. Also correct guidelines in walking, sitting, standing and lifting techniques are taught to the patient. The patient is gradually introduced to normal daily activities.
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In India, these specialized surgeries are performed in our world class hospitals that provide a benchmark in comprehensive spine care for such complex and advanced surgeries. The procedure is performed by a highly qualified neurosurgeon or an orthopedic surgeon with a master of surgery (MS) degree who has trained for years in these types of surgeries. The hospital should have a state of art diagnostic centre with MRI, CT scan and EEG facilities. The operation theatre should be well equipped with all the required instruments such as endoscope, fluoroscope, catheters, low temperature resistor and other micro instruments and should maintain high standards of hygiene and disinfection.Refer a Patient
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