Nucleoplasty

Back problems are among the most common ailments affecting adults, and are potentially one of the most debilitating. For most people, back pain can be resolved with a regimen of rest, therapeutic exercise, and/or medication. For those experiencing back pain from disc herniation (bulge), often the pain is prolonged and severe, and does not respond to conventional treatment.

For these patients, Nucleoplasty is a minimally invasive alternative for treating the disc bulge. Performed in an outpatient setting, this procedure uses a needle that emits radio waves to shrink a disc bulge by dissolving excess tissue. This relieves the pressure inside the disc and on the nerves responsible for causing pain. The procedure should take less than one hour.

Procedure preparation

A CDI technologist or nurse will contact you 24-48 hours prior to your appointment to review medications you are currently taking, especially pain medications and blood thinners, discuss known allergies and your medical history, as well as answer your questions.
Contact your doctor before you stop taking any medication.
Please bring to CDI previous imaging study results (MRI, CT, x-rays) such as films, reports, or CD-ROMs, if available.
Do not eat or drink anything 4 hours prior to your any procedure if you are receiving I.V. sedation.
You will need someone to drive you home and stay with you for 12 hours post-procedure due to the effects sedation medications. Please make any necessary arrangements.
Please notify a member of CDI’s staff if you are nursing or if there is a chance you may be pregnant.

During the procedure – what to expect

Nucleoplasty is an advanced injection procedure that is performed in our Ambulatory Surgery Center (ASC) suite or local surgery center, where we are able to offer I.V. sedation and monitoring by a nurse.
If you choose to have sedation, once you arrive, you will have an I.V. needle placed in your arm so that you can receive the medication.
You will be awake during the procedure to provide important feedback to the radiologist, but the sedative will help diminish anxiety and any discomfort.
After you are in position on the table, your lower back will be numbed with a local anesthetic (numbing medication).
Under x-ray guidance (fluoroscopy), a small, “tube-like” needle is placed into the center of your bulged disc. You may experience mild discomfort during this part of the procedure.
A small, specialized wand is inserted through the needle, where it is heated to create a series of channels within the disc by dissolving tissue.
By reducing the amount of excess tissue within the disc, this treatment can potentially reduce the size of the bulge, and also relieve pressure inside the disc, as well as on the adjacent nerves.
The wand will then be slowly withdrawn to its original position while thermally sealing the new channel.
Throughout the procedure, a radiologist and nurse will monitor your condition and comfort level closely.
The number of channels created are dependent on the disc size. At the end of the procedure, the wand and needle will be removed.

After the procedure – what to expect

A small bandage will be placed over the needle insertion site and you will be taken to the ASC recovery area until you are ready to go home.
Due to the sedation, a nurse will review some guidelines that you will be asked to follow post-procedure (pertaining to driving, drinking alcoholic beverages, etc.).
Adult supervision is necessary for the remainder of the day due to the effects of sedation.
CDI will provide you with general activity and physician rehabilitation guidelines. Ask your referring physician about long-term activities, such as return to work and rehabilitation.
You may experience increased symptoms for 7-10 days, until the disc begins to heal.
Prescription medications may be given to relieve these symptoms.
Complications are rare, but you are encouraged to keep a record of symptoms you experience following the procedure and report them to the radiologist at the time of the follow-up visit, usually 7 to 14 days after the procedure.

Possible side effects

Complications are rare, but you are encouraged to keep a record of any symptoms you experience following the procedure and report them to the radiologist at the time of the follow-up visit, usually 7 to 14 days after the procedure.
Physical therapy may be ordered at the time of the follow-up visit to maximize your overall recovery.

Questions?
If you have additional questions about your appointment or our services, contact your local CDI center.