Disc Nucleoplasty Spine Surgery

Q1 What is meant by herniated disc?

 

A1 The small bones or vertebrae that form the spine are separated by cushion like discs that functions as shock absorbers and protect the vertebrae against damage during movement. Spinal disc consists of two parts. Outer thick and strong ring shaped protective part called Annulus fibrosus which is a fibrous cartilage surrounding the inner gelly like soft spongy substance called Nucleus Polposus.Hernia is the bulging of an organ or a part of it beyond the cavity or the place which normally accommodates it. Herniated disc refers to the bulging or protrusion of the spinal disc beyond the space between the vertebrae, which usually contains it. This condition is referred to as "Slipped disc or ruptured disc" in layman's terms.

​

Q2 What are the causes of herniated or slipped disc?

 

A2 The thick and strong ring like protective part of the disc(Annulus Fibrosus) may get damaged or weakened due to 

• Injury or,
• Age related disc degeneration

This leads to the pressure from the spongy gel like inner portion of the disc(Nucleus Pulposus) to bulge outwards or break the outer protective shell with compromised structure, causing a condition called herniated Disc. This abnormal bulging or herniated disc puts pressure on the nerve roots in the spine, irritates them and causes symptoms.

 

Q3. What are the symptoms associated with herniated discs?

 

A3 Herniated disc mostly affects lumbar region (lower back) and is characterized by the following symptoms:

 

• Excruciating pain in the lower back, overlying the herniated disc, surrounding area and radiating Leg pain(one or both legs)

• Tingling

• Loss of reflexes

• Weakness

• Numbness

 

Q4. What is done in Disc nucleoplasty?

 

A4 Disc Nucleoplasty is a minimally invasive procedure that involves decompression of the nucleus of the herniated disc.It is an advanced and clinically proven treatment method for disc herniation.It involves the usage of a minimally invasive thin catheter to create an exactly1mm passage in the nucleus of the disc. A microengineered alloy transmitter is advanced into the disc. Radiowave signals are sent into the soft spongy jelly like nucleus of the herniated disc, through the transmitter. Low temperature ionized gas is produced by the radiowaves that breaks the molecular bonds of the jelly like nucleus, reducing tissue volume. When the injection process is done, the transmitter is taken out. Now, the pressure on the annulus fibrosus protective tissue is relieved as a result of removal of the jelly like nucleus tissue. The adjacent nerve roots are no longer irritated as the bulge has now receded.

 

Q5 What are the types of disc herniation?

 

A5 There are normally 3 types of disc herniation namely:

1. Protrusion or the bulging of the disc with intact Annulus Fibrosus and posterior ligaments.
2. Disc herniation with partial or complete breakage of the Annulus Fibrosus(outer thick and strong fibrous part of the disc)
   1. Inner annulus fibres are disrupted and outer fibres are intact.
   2. Complete disruption of Annulus fibrosus with inner jelly like Nucleus pulposus forming a tail that is extending into the disk space.
3. Sequestration- Under this type of disc herniation a free part of the Nucleus pulposus,without a tail, occupies the disc space.There is a little chance of this exuded disc material to get reabsorbed on its own.

​

Q6 What are the usual locations of disc herniation?

 

 A6 Usual locations of disc herniation are:

1. Central

• Rare
• Patient experiences more back ache than leg pain.
• Involves multiple nerve roots
• Calls for urgent surgical intervention if associated with neurological deficit sysptoms or the complaints involving the nervous system.
• Patient may suffer from urinary or bowel incontinence(No control over passing of urine or defecation).

     2.Posterolateral(to the posterior on the side)

• Common
• Involves only one nerve root, the lower one.For eg if disc is herniated at L4 and L5 level, the nerve affected would be L5.

     3.Foraminal

• Occurs in less than 10%
• Affects the nerve passing through that foramen(hole or opening formed by two adjecent vertebrae). For eg in L4-L5 foraminal herniation, L4 nerve will be affected.

​

Q7 How much time does Disc Nucleoplasty take?

 

A7 Disc Nucleoplasty takes around 25 to 30 minutes.

 

Q8 What kind of anesthesia is given for Disc Nucleoplasty procedure?

A8 No general anesthesia is required. Local or topical anesthesia along with light sedation will do. Patient is usually awake during the entire procedure.

 

Q9 What are the benefits of Disc Nucleoplasty?

 

A9 The benefits that disc nucleoplasty offers, are the following:

• No hospital stay required

• 25 to 30 minutes procedure

• Rapid acting in relieving symptoms,as compared to drug therapy

• Minimally invasive procedure

• No general anesthesia required.

• Makes use of FDA approved device

• Clinically proven treatment method

• Early resumption of activities

 

 

​

Disc Nucleoplasty Spine surgery in India

• Most advanced Spine surgery at the most affordable cost.

• Minimally invasive and endoscopic spine surgery techniques are being carried out to give maximum benefit to the patient such as quick recovery,short or no hospital stay,minimal scar formation which is aesthetically good and early resumption of activities.

• Best hospitals in India for spine surgery with state of the art infrastructure and most advanced technology in place

• Globally trained and highly experienced spine surgeons

• High success rate

• Great ambience

• Compassionate staff to look after

• Hospitals accredited with international organizations such as JCI(Joint commission International) for quality standards.

• FDA approved device is used. 

• Language no barrier. English speaking people and if required, translators are available for your convenience.

• Most economical accommodation available at a walking distance from the hospital. Wide range of options starting from guest house, service apartments to five star hotels, best suited to your budget and choice.

• Good flight connectivity

• India has a diverse and rich cultural heritage. You can witness its beauty and uniqueness. It offers most conducive environment for recuperation.

Dr K.S Narang

M.B.B.S,M.S(GeneralSurgery), M.Ch (Neurosurgery)

IGASS Spine Fellow Klinikum rechts der Isar Department of Neurosurgery, Technical University of Munich, Germany

Minimally Invasive Spine Surgery,Wooridul Spine Hospital, Seoul, Korea

Consultant – Neurosurgeon, Institute of Neurosciences

Medanta – The Medicity,Gurgaon,Delhi-NCR

Dr Sudhir Dubey
MBBS, M.S, MCh(Neurosurgery)
Fellowship in Endoscopic Skull Base Surgery UPMC, Pittsburgh, USA
Additional Director,Neurosurgery
Institute of Neurosciences
Medanta – The Medicity,Gurgaon,Delhi-NCR

Dr Bipin Swarn Walia
MBBS,MS(General Surgery), M.Ch(Neurosurgery)
Director – Neurosurgery & Head - Unit 1 & Neuro Spine Program
Max Super Speciality Hospital, Saket, Delhi

Dr (Maj Gen) Prakash Singh
MBBS, MS(Surgery), Mch(Neurosurgery)
Director & Sr. Consultant Neurosurgery
Max Smart Super Specialty Hospital,Saket,New Delhi

 

 

Dr Puneet Girdhar

MBBS,MS,MCh(Ortho)

Director Orthopedics Spine Surgery

BLK Orthopedics centre for Orthopedics, Joint reconstruction and Spine Surgery

BLK Super Specialty Hospital, New Delhi.

Dr P.K Sachdeva

MBBS,MS,MCh(Neurosurgery)

Director & Head, Neurosurgery