Dietrich H.W. Groenemeyer MD, Presenter: Nothing to Disclose

Athour Gevargez MD, Abstract Co-Author: Nothing to Disclose

Percutaneous Nukleoplasty is a new minimally invasive technique to decompress a herniated disc. The purpose of this study was to determine the efficacy and safety of Nukleoplasty under CT/Fluoroscopy guidance in the treatment of radicular and non radicular low back pain after positive discography.

n the period between November 2002 and January 2004, 33 outpatients with non radicular low back pain and monoradicular leg pain with and without sensory motory disorders due to a herniated discs were treated with Nukleoplasty. All these patients did not react to conservative and image guided interventional pain therapy after a period of at least six weeks. An CT an C-arm guided discography was performed before the Nukleoplasty. Nukleoplasty were performed under CT and C-Arm control. The treatments were carried out under local anesthesia without any sedation. Pain was assessed with the help of a visual analogue scale. Back pain related disability was measured with the Hannover Functional Ability Questionaire. MR images were examined to judge disc prolaps after the procedure. Follow-up ranged from 2-16 months

A significant low back and radicular pain relief was observed in 26 from 33 patients after a period of 3 to 21 days after the procedure. There were no serious cases of postoperative complications such as infection, bleeding and nerve injury.Most of the patients were satisfied with their treatment procedure and result and reported that they would undergo the same treatment again.

The image guided percutaneous Nucleoplasty is a minimal invasive method of disc tissue removal to treat persistent low back pain due to degenerated lumbar disc after a positive discography. The combination of CT and Fluoroscopy guidance make the procedure more secure and fast. The treatment under local anesthesia means less complications and makes this minimal invasive procedure for out patients possible.

Groenemeyer, D, Gevargez, A, Image-guided Percutaneous Lumbar Disc Decompression Using Nucleoplasty, a New Minimally Invasive Procedure in the Treatment of Low Back Pain.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4411699.html