Percutaneous Nucleotomy

A percutaneous nucleotomy is a minimally invasive procedure involving the removal of the inner material of a bulging or herniated intervertebral disc that has impinged a nerve root or the spinal cord.

A bulging or herniated disc occurs mainly due to age, but a variety of injuries can lead to the conditions as well. As you age, the normally moist and spongy cartilage discs between the vertebrae begin to dehydrate. This loss of water begins to weaken the usually fibrous outer layer of the disc, called the annulus fibrosus. The nucleus pulposus is the jelly-like material found in the center of the disc. The inner material can push outward as the outer wall continues to break down, which can cause a bulge in the wall, or even a rupture (herniation) in the wall that allows disc material to escape. Pain, tingling, weakness, and numbness may develop if the disc impinges upon the spinal cord or one of its nerve roots.

Reasons to Consider a Percutaneous Nucleotomy

The percutaneous nucleotomy is recommended only if conservative treatments such as bed rest, pain medications, exercise, and physical therapy have not helped alleviate symptoms. The procedure begins with the insertion of a needle into the damaged disc. A video probe (endoscope) equipped with a laser then vaporizes some or all of the nucleus pulposus. The removal has two purposes:

• To relieve pressure from the afflicted nerve root or spinal cord.
• The shift of the nucleus pulposus allows the surgeon, if needed, to redirect remaining disc material away from the spinal cord or nerve root. This may be helpful in avoiding a painful bulge or herniation in the future.

While in most cases, symptoms of a bulging or herniated disc may clear up on their own within a few weeks to a few months, a percutaneous nucleotomy may be necessary to relieve chronic, or long-lasting, pain. The procedure typically is performed on an outpatient basis, allowing patients to go home the same day to rest and recover faster than open back surgery. Furthermore, because a small incision is used, minimal scarring occurs.

Laser Spine Institute

Laser Spine Institute offers several minimally invasive procedures to treat back and neck pain. If you have exhausted conservative treatments to deal with your pain, contact our orthopedic specialists, who have helped tens of thousands of people rediscover their lives without back and neck pain.