Herniated Disease Disc

Herniated Disease :

Herniated discs are extremely common back injuries. They occur when the thick outer layer (annulus fibrosus) of an intervertebral spinal disc bulges or ruptures. Sometimes, the gel-like interior of the disc (nucleus pulposus) will actually break through the outer layer and leak out into the body. This is called a ruptured or extruded disc.

Herniated Disc Treatment :

Herniated disc treatment is a diverse field with many options. There are both medical and alternative treatments available. It is often difficult and confusing for the patient to know what is right for them -

Discectomy is the most common surgical procedure used to correct herniated discs.. In this procedure, part of the herniated disc is removed, hopefully eliminating the pain. Disc removal procedures have been performed for over 60 years. The modern version is much improved, compared to the overly invasive procedures done years ago

Nucleoplasty is a minimally invasive procedure developed to treat patients with contained, or mildly herniated discs. Nucleoplasty literally means removal of the nucleus (nucleus pulposis is the center gel-like substance of the disc.) The outer band-like substance of the disc is the annulus fibrosis. Typically when a disc herniates, the annulus fibrosis opens and allows the nucleus pulposis to protrude and compress structures such as nerves. Nucleoplasty does not involve an incision. A special access needle is placed into the disc under x-ray guidance. A wand-like device is then inserted through the needle and into the disc. The device uses heat to remove disc material and seal the channel made by the needle. Several channels are made depending on how much disc material needs to be removed.

Pre Pocedure Preaparation :

This procedure is done under local anesthesia (“novacaine.”) Most of the patients also receive intravenous sedation and analgesia, to help them relax and make the procedure easier to tolerate. The amount of sedation given depends upon the patient. You need to be awake enough to tell the doctor what you are feeling.

Procedure:
The procedure is performed in a surgical center with fluoroscopic (x-ray) guidance. Nucleoplasty is done with the patient lying on the stomach. Intravenous sedation is given to help with comfort and relaxation. The skin is cleaned with an antiseptic solution and the back is numbed with a local anesthetic before the procedure is performed. The patient is monitored with an electrocardiogram blood oxygen-monitoring device.

The surgeon uses a needle, guided by fluoroscopic x-ray, to introduce a special instrument into the nucleus. The surgeon’s goal is to pull leaking nuclear material back into the center of the nucleus. This procedure is performed using a special “wand” The wand is moved back and forth in the nucleus creating destroyed nuclear channels, thereby decreasing volume of the nucleus.



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