Treatment of intervertebral disc degenerative disease using percutaneous nucleotomy–an overview of less invasive procedures

  • Miran Jeromel Oddelek za diagnostično in intervencijsko nevroradiologijo, Klinični inštitut za radiologijo, Univerzitetni Klinični center Ljubljana, Zaloška cesta 2, 1000 Ljubljana, Slovenija
  • Sergeja Kozar Klinični oddelek za anesteziologijo in intenzivno terapijo operativnih strok, Univerzitetni Klinični center Ljubljana, Slovenija
Keywords: herniated intervertebral disc, percutaneous disc decompression, nucleotomy, discoplasty, less invasive procedures

Abstract

Background: Less invasive treatment methods for intervertebral disc disease and decompression of neural structures as a consequence of contained disc herniation represent an alternative to surgical procedure. Percutaneus nucleotomy uses a percutaneous approach to the intervertebral disc. The article presents the evolution of numerous procedureds in clinical practice.

Methods: Percutaneous nucleoplasty is a fluoroscopy-guided procedure which enables controlled and safe entrance into the intervertebral disc. The procedure is performed under strict aseptic conditions, using a local anaesthesia with the patient under analgosedation. Based on the principle of therapeutic intradiscal action, the procedures can be divided into three groups: chemical (chemonucleolysis with chimopapain, alcohol, ozone), mechanical (automated percutaneous lumbar discectomy – APLD, arthroscopic discectomy) and thermical methods (laser, radiofrequency ablation, intradiscal electrothermal annuloplasty – IDET, Coblation®).

Results: Percutaneous nucleotomy by the majority of the mentioned procedures results in a therapeutic effect (reduction of pain and decompression of neural structures). Fast recovery represents a major advantage of less invasive treatment.

Conclusions: Less invasive method (nucleotomy using different procedures) represents a successful alternative approach to surgical discectomy. Proper patient selection and safe technique are mandatory in order to achieve a good clinical outcome.

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How to Cite
1.
Jeromel M, Kozar S. Treatment of intervertebral disc degenerative disease using percutaneous nucleotomy–an overview of less invasive procedures. ZdravVestn [Internet]. 1 [cited 17Sep.2019];83(3). Available from: https://vestnik.szd.si/index.php/ZdravVest/article/view/1138
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