Percutaneous cervical nucleoplasty using coblation technology. Clinical results in fifty consecutive cases.
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.
- SourceAvailable from: PubMed Central[Show abstract] [Hide abstract]
ABSTRACT: Nucleoplasty is a minimally invasive spinal surgery using a Coblation® technique that creates small voids within the disc. The purpose of this study was to evaluate the efficacy of cervical nucleoplasty in patients with cervical disc disorder. Between March 2008 and December 2009, 22 patients with cervical disc disorders were treated with cervical nucleoplasty after failed conservative treatment. All procedures were performed under local anesthesia, and fluoroscopic guidance and voids were created in the disc with the Perc™ DC Spine Wand™. Clinical outcomes were evaluated by the Modified Macnab criteria and VAS score at preprocedure, postprocedure 1 month, and 6 months. Six patients had one, eight patients had two and eight patients had three discs treated; a total of 46 procedures was performed. Mean VAS reduced from 9.3 at preprocedure to 3.7 at postprocedure 1 month and to 3.4 at postprocedure 6 months. There was no significant complication related to the procedure within the first month. Outcomes were good or excellent in 17/22 (77.3%) cases. Postprocedure magnetic resonance imaging was acquired in two patients after two months showing morphologic evidence of volume reduction of protruded disc material in one patient but not in the other. Percutaneous decompression with a nucleoplasty using a Coblation® technique in the treatment of cervical disc disorder is a safe, minimally-invasive and less uncomfortable procedure, with an excellent short-term clinical outcome.The Korean journal of pain 03/2011; 24(1):36-43. DOI:10.3344/kjp.2011.24.1.36
- [Show abstract] [Hide abstract]
ABSTRACT: We set out to assess the efficacy of radiofrequency-induced intradiscal nucleoplasty in reducing pain in symptomatic patients with MRI-defined lumbar disc herniation and their satisfaction with the procedure. We compared the patients' pain intensity and severity of disability scores before and after undergoing the procedure in a retrospective questionnaire. These patients reported statistically significant reduction of pain intensity and disability level after the procedure. We conclude that radiofrequencyinduced intradiscal nucleoplasty is an acceptable alternative minimally invasive procedure in relieving the symptoms of patients with lumbar disc herniation. Radiofrequency-induced intradiscal nucleoplasty, coblation therapy, percutaneous lumbar disc decompression, intervertebral disc herniation, low back pain.07/2013; 7(2):18-20. DOI:10.5704/MOJ.1307.009