Nucleoplasty as an Alternative Intradiscal Therapy in Patients with Lumbar Disc Herniation

ABSTRACT

OBJECTIVE: The nucleoplasty ablates, coagulates and decompresses the nucleus pulposus by way of high-density plasma field rather than by way of high thermal energy. The authors intended to describe the effects, indications and technical details of nucleoplasty. METHODS: From August 2001 to January 2002, the authors performed nucleoplasty for 40 consecutive patients (45 levels) and evaluated the short-term(mean 3 months) result after the procedure according to Macnab criteria. Exclusion criteria were same for the other percutaneous procedures, significant or ruptured, sequestered disc material, spinal stenosis, spinal instability, etc. Intraoperative discogram was prerequisite for determination of the precise causative level. Average operation time was 40 minutes, and patients discharged on the next day after the procedure. RESULTS: Male was outnumbered female by 21 to 19 and age was ranged from 20 to 67 years old(mean 42.9). Procedures were performed at single level in 35 cases and at two levels in 5 cases. The L4-5 level was the most commonly involved. According to Macnab's outcome criteria, excellent and good outcome was achieved in 35 patients(87.5%), and fair and poor outcome was in 3(7.5%) and 2(5%) patients, respectively. CONCLUSION: Nucleoplasty by using coblation method in patients with lumbar disc herniation shows immediate relief of leg and back pain in 87.5% of the patients during the short span of follow-up. However, data collection with respect to the lengthening of population number and follow-up span, and refinement of strict inclusion/exclusion criteria are prerequisite in near future.