Article

Percutaneous cervical nucleoplasty using coblation technology. Clinical results in fifty consecutive cases.

Policlinico Casilino, UOC Neurochirurgia, Roma, Italy.
Acta neurochirurgica. Supplement 02/2005; 92:73-8.
Source: PubMed

ABSTRACT Conventional open cervical discectomy, with or without bony fusion, in common neurosurgical knowledge is considered the standard treatment for cervical disc herniation. Percutaneous procedures are minimally invasive and offer decreased morbidity, require no bone graft and promise shorter recuperation time. Nevertheless, candidates for a percutaneous procedure as inclusion criteria must complain of symptoms related to contained herniated disc or focal protrusion. It does not substitute conventional open procedures required for extruded discs. We used the coblation technology for nucleoplasty of the cervical intervertebral discs. Early and long-term effects and/or complications observed with this procedure have not been reported yet. Fifty consecutive patients presenting with contained herniated cervical disc or focal protrusion causing compression of the cervical roots or cervical pain underwent a nucleoplasty procedure on the pathological disc. A randomized control group of twenty patients was treated conservatively with medical and physical therapy in the same period and completed the identical follow-up form. In the nucleoplasty group results were complete resolution of symptoms in 80% of cases, only 10% referred some residual cervical or radicular pain and are still under follow-up with a wait-and-see prospective. Patients who did not have a clinical resolution were treated with alternative traditional methods (10%). Despite the relative low cases number and the limited follow-up the encouraging results induce us to utilize this technique in well-selected cases.

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    • "However, compared to other percutaneous decompression or even lumbar nucleoplasty, there is a relative lack of research on and clinical experience with cervical nucleoplasty. Cervical nucleoplasty has only limited evidence (level IV) in the literature concerning the technique like lumbar nucleoplasty, and indications are limited to contained herniation and protrusion similar to the lumbar area [1,2,5]. Therefore, the goal of this study is to evaluate on the efficacy, side effects and patient satisfaction with cervical nucleoplasty performed on patients with cervical disc disorders that were unresponsive to conservative treatments. "
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