Lewis S Sharps | PubMed Health

PubMed2006

Side effects and complications after percutaneous disc decompression using coblation technology.

OBJECTIVE: To report the short-term side effects and complications after percutaneous disc decompression utilizing coblation technology. DESIGN: Following institutional review board approval, consecutive patients who were to undergo percutaneous disc decompression using coblation technology (nucleoplasty) were prospectively enrolled. Patients were questioned preoperatively, postoperatively, and 24 hrs, 72 hrs, 1 wk, and 2 wks postprocedure by an independent reviewer regarding 17 possible symptom complications, which included bowel or bladder symptoms, muscle spasm, new pain, numbness/tingling or weakness, fevers/chills, rash/pruritus, headaches, nausea/vomiting, bleeding, and needle insertion site soreness. Statistical analysis was performed using Wilcoxon's signed-rank test. RESULTS: A total of 53 patients enrolled, of whom four patients dropped out. Two patients had increased symptoms and opted for surgery. Two patients could not be contacted. The most common side effects at 24 hrs postprocedure was soreness at the needle insertion site (76%), new numbness and tingling (26%), increased intensity of preprocedure back pain (15%), and new areas of back pain (15%). At 2 wks, no patient had soreness at the needle insertion site or new areas of back pain; however, new numbness and tingling was present in 15% of patients. Two patients (4%) had increased intensity of preprocedure back pain. There were statistically significant reductions in visual analog scale score for back pain and leg pain (P < 0.05). CONCLUSIONS: Based on this preliminary data, nucleoplasty seems to be associated with short-term increased pain at the needle insertion site and increased preprocedure back pain and tingling numbness but without other side effects.

Adolescent↗

PubMed2002

Percutaneous disc decompression using nucleoplasty.

The objective of this study was to evaluate the effectiveness of Nucleoplasty for decompression of contained herniated discs, in a prospective, single site study that evaluated 49 consecutive patients with complaints of back with or without leg pain secondary to a contained focal protrusion. Access to the disc was obtained via the posterolateral discography approach, with a 17-gauge introducer needle inserted through the annulus and into the nucleus. The introducer remained in place within the outer annulus during the entire procedure, providing access for the SpineWand into the nucleus. The procedure was performed on an outpatient basis. One month, three month, six-month and twelve month outcomes were assessed by the treating physician and support staff. Success was defined as a minimum 2-point reduction on a Visual Analog Scale (VAS), patient satisfaction, absence of narcotic use, and return to work if not working secondary to back pain. The pre-procedure and post-procedure VAS differences were 4.28 (p<0.001), 4.66 (p<0.001), 4.75 (p<0.001), and 3.3 (p=0.002) at the one month, 3 month, 6 month, and 12 month intervals respectively. Overall, there was a 79% success rate, with 67% success in the group of patients that had previous surgery and 82% success in the group that had no prior surgical intervention. Results indicate that Nucleoplasty may be a promising and efficacious minimally invasive procedure for the treatment of symptoms associated with contained herniated discs. Randomized, controlled studies with subgroup analysis are required to further delineate the role for this procedure.

Journal Article↗