Percutaneous Lumbar Discectomy (Nucleoplasty) at DRHC Dubai

This is what some spine surgeons and interventional radiologists refer to as Non-Surgical Treatment. This procedure is considered a minimally invasive surgery in which special instruments are inserted under X-ray or CT guidance in the disc space, which allows mechanical excision of the disc material (decompression) from the intervertebral space. I prefer to describe it as an indirect discectomy, and I feel it is suitable in cases of small, far-lateral, mild lumbar disc bulges rather than for large prolapses, but the results for large posterior-lateral or central disc prolapses are not encouraging at all, and the success rate is limited.

Intradiscal Electrothermal Nucleoplasty (IDET), is a similar method but uses a radio-frequency generator to produce thermal energy within the disc to help shrink and decompress the disc bulge, rather than extracting the disc material mechanically.

The alternative is to use a Laser generator (Laser Nucleoplasty) rather than radio-frequency to produce the same effects. The success rate of these methods is approximately 50%; hence, careful patient selection has to be carried out to increase the success rate. These methods are not without risk of complication, and in fact, the rate of complication is higher than formal microdiscectomy or endoscopic discectomy in some reports.

Nucleoplasty should never be considered a replacement for microdiscectomy surgery or attempted before microdiscectomy as a prior option. It is indicated on its merits whenever it is suitable. I believe it is a valuable option for selected patients only.

Please follow the links below to read more about the various techniques.

• Percutaneous Lumbar Discectomy (Nucleoplasty)
  
• Surgical Lumbar Microdiscectomy
• Minimally invasive microdiscectomy

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