PERCUTANEOUS PLASMA DISC DECOMPRESSION

What is Percutaneous Plasma Disc Decompression?
Percutaneous Plasma Disc Decompression 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.

How many discs are treated?
Based on your symptoms and your MRI, your doctor will determine which disc(s) may be causing your pain. Typically, only one disc is treated at a time.

How long does Nucleoplasty take? Percutaneous Plasma Disc Decompression typically takes less than an hour to complete.

Will the injections hurt?
The procedure involves inserting a needle through skin and deeper tissues, so there is some discomfort involved. However, your doctor will numb the skin and deeper tissues with a local anesthetic using a very thin needle prior to inserting the needle into the disc. Most of the patients receive intravenous sedation and pain medication, which makes the procedure easy to tolerate. You may have a flare-up of your back pain after the injection, but this gets better in a day or two and can usually be managed with ice packs and oral pain medication.

Will I be asleep for this procedure?
No. 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.

What should I do after the procedure?
We advise patients to take it easy the day of the procedure. You may need to apply ice to the affected area for 20-30 minutes at a time for the next 48 hours. Your doctor will provide specific activity restrictions if indicated. Typically driving, lifting, bending/twisting at the waist are restricted in the first few weeks. Formal physical therapy may begin at 2 weeks post-procedure.

What are the risks and side effects of Percutaneous Plasma Disc Decompression?
Generally speaking, this procedure is safe. However, with any procedure there are risks, side effects, and possibility of complications. The most common side effect is discomfort, which is temporary. Other risks, although rare, include infection, bleeding, and worsening of symptoms. Fortunately, because the procedure is performed with x-ray in a controlled environment, serious side effects and complications are extremely rare.

What is the success rate of Percutaneous Plasma Disc Decompression?
According to the International Spine Injection Society, a recent one year study indicated a success rate of 79%, and overall patient satisfaction of 89%. There have been over 35,000 patients treated to date with no unresolved complications.

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