Disc Protrusion: Percutaneous Endoscopic Disc Nucleoplasty

Many patients with back pain show no clear indication of a herniated disc. Using spine MRI, protrusion of the intervertebral discs can be diagnosed. This protrusion can put pressure on nerves or the spinal cord and can cause persistent chronic back pain. Normally this kind of back pain responds well to conservative treatment options. If after six weeks, conservative treatment has not been successful, your spine doctor should consider an intradiscal procedure: The disc protrusion can be reduced by treating the liquid core of the disc simply by using a fine needle. This needle allows a radiofrequency instrument to enter the core of the disc, thereby avoiding all the surgical risks associated with open back surgery. This is essentially the principle of Nucleoplasty. Nucleoplasty, as a minimally invasive treatment, covers only smaller disc herniations or disc bulges that have not yet broken through the solid fibre ring of the disc and are therefore not accessible via an open surgical procedure (surgical removal of the disc material). Percutanoeus Laser  Nucleoplasty is safe for patients and is a minimally invasive procedure, which produces very good results, without the risks and postsurgical complications associated with open back surgery.

What is the principle of Percutaneous Laser Nucleoplasty?

Nucleoplasty is a minimally invasive procedure for reducing the internal pressure of the spinal disc. Nucleoplasty by thermal coblation is indicated if there is a significant protrusion with a bulging fibre ring, however, there should not be any evidence of disc herniation which has broken through the disc wall. The principle is based on a minimal shrinkage of the gelatinous disc nucleus. With the resulting shrinkage, the bulging disc retracts, the intradiscal presuure decreases and the  compressed nerve is released and the leg pain and back pain subside.

Which patients are suitable for Nucleoplasty?

Dr. Koura is one of the best spine specialists in th Egypt , North Africa and the Middle East and the reason is the deep clinical and technical experience in dealing with patients suffering from back pain. The fact that Dr Koura could offer more than 10 different procedures to treat back pain, including percutaneous laser nucleoplasty, is associated with the fact that the treatment plan is customized to each patient according to his own case. Proper patient selection increases the probability of a good outcome. Patients require a thorough clinical checkup. The stability of the spine should be assessed with dynamic X-ray images. The discs can be investigated in detail via MRI imaging.

Details of the procedure:

Following partial anaesthesia, Dr Koura inserts a thin needle through the back and into the herniated disc .  A small radiofrequency probe is inserted through the needle and into the disc. This device sends pulses of  laser to dissolve small portions of the disc nucleus. The empty space created by this procedure, allows the disc to reabsorb the herniated part of the disc, which in turn leads to pressure relief.  After the needle is removed, the area is covered with a small bandage, no suturing is required. All this is done with the guidance of fluoroscope and under the effect of sedation and local anesthesia .

Results of Nucleoplasty:

The chances of success with this method are very good with over 80 % patient satisfaction rates. The precondition for this success rate, however, is a thorough medical investigation and patient selection. The Neurosurgical consultant needs to rule out all other possible causes of back pain.

Rehabilitation:

Patients may need one day of bed rest and may resume all normal activity within one to six weeks. Nucleoplasty treatment is, however, only the first step of the long-term solution. Recovery, including pain relief, will be gradual and can take 8-12 weeks to complete. An extensive rehabilitation program will be necessary to ensure the success of the nucleoplasty. Physical activity should be monitored and only gradually increased. "Back friendly" behaviour such as paying attention to posture, is always advised. It is especially important to strengthen the muscles supporting the vertebral spine and adopt a "back friendly" lifestyle

For more informations about cervical disc prolapses visit the link

https://drkoura.com/en/blogs/neck-pain/treatment-of-cervical-disc-prolapses-with-non-surgical-techniques

For more informations about disc prolapses visit the link

https://drkoura.com/en/blogs/lower-back-pain/12-interventions-for-the-treatment-of-disc-prolapse