title: Outcome of nucleoplasty in patients with radicular pain due to lumbar intervertebral disc herniation.
abstract: BACKGROUND
  Nucleoplasty (percutaneous lumbar disc decompression) is a minimally invasive procedure that utilizes radiofrequency energy as a treatment for symptomatic lumbar disc herniation, against open microdiscectomy, which would be the mainstay treatment modality. The literature reports a favorable outcome in up to 77% of patients at 6 months.
  
  
  OBJECTIVE
  To evaluate the effectiveness of nucleoplasty in the management of discogenic radicular pain.
  
  
  METHODS
  The medical notes of 33 patients, admitted for nucleoplasty between June 2006 and September 2007, were reviewed retrospectively. All had radicular pain, and contained herniated disc as seen on magnetic resonance imaging (MRI) of lumbosacral spine. Patients were followed up at 1 and 3 months post-procedure. The outcome measures employed in this study were satisfaction with symptoms and self-reported improvement.
  
  
  RESULTS
  Thirty-three cases were examined (18 males and 15 females). Twenty-seven procedures were performed with no complications and six were abandoned due to anatomical reasons. There were 18 and 15 cases of disc herniation at L5/S1 and L4/5 levels, respectively. Four weeks following the procedure, 13 patients reported improvement in symptoms, and 14 remained symptomatically the same and subsequently had open microdiscectomy.
  
  
  CONCLUSIONS
  Nucleoplasty has been shown to be a safe and minimal-access procedure. Less than half of our selected cohort of patients reported symptomatic improvement at 1-month follow-up. We no longer offer this procedure to our patients. Possible reasons are discussed.
authors: Department of Neurosurgery, Cork University Hospital, Cork, Ireland.
authors: Sunny
authors: S
authors: Ogbonnaya
authors: Chandrasekaran
authors: C
authors: Kaliaperumal
authors: Abdulla
authors: A
authors: Qassim
authors: Michael
authors: M
authors: O'Sullivan
keywords: Lumbar disc herniation; nucleoplasty; radicular pain
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