Patients with prolapsed intervertebral disc in their lumbar or cervical spine would present with either localized axial pain or associated with radicular symptoms such as leg or arm pain.

Depending on the severity of the protrusion, other non-surgical options can be a treatment option, apart from open surgical technique of laminectomy and discetomy.

Nucleoplasty is a minimally invasive technique recently developed to treat leg and or low back pain associated with contained herniated disc(s). Small disc protrusion with minimal canal stenosis and possible increased discal pressure would be suitable candidates for this procedure.

Under fluoroscopic guidance, a small introducer needle is placed percutaneously into the center of the target disc to act as a portal for a wand-like coblation device. The device uses radiofrequency energy to both vaporize and remove disc material and seal the channel created by each pass of the wand. Like removing fluid from a pressurized balloon, these channels decompress the disc and allow for a retraction of any disc protrusion or herniation that may be irritating nearby nerve roots.

To increase the success of this technique, often a diagnostic discography may be performed to identify the correct level of discogenic pain, especially when there may be multiple disc protrusions. A test solution is injected into each suspected disc to elicit a response from the patient. When we arrive at the concordant pain (with patient’s usual pain), there is greater likelihood that particular disc is the cause of the back or neck pain.