{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T06:35:45Z","timestamp":1726468545752},"reference-count":77,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2006,1]]},"abstract":"<jats:sec><jats:title>Object<\/jats:title><jats:p>Nucleoplasty is a minimally invasive surgical procedure for disc decompression developed to treat patients with symptomatic contained herniated discs. Nucleoplasty uses nonheat-driven radiofrequency energy to ablate and coagulate the disc nucleus via a percutaneous \u201cdiscography\u201d trajectory under fluoroscopic guidance. In this study the authors evaluated pain, functioning, and quality of life (QOL) in patients with radicular leg and back pain who underwent nucleoplasty-based percutaneous disc decompression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study was designed as a prospective nonrandomized longitudinal cohort study in an academic medical center. Sixty-seven patients (mean age 41 years) with primarily radicular pain due to a contained disc herniation underwent nucleoplasty-based decompression in an outpatient setting. Patients completed the Medical Outcomes Study 36-Item Short Form (SF-36) Health Survey, EuroQol 5D (EQ5D), and a visual analog scale (VAS) for pain pre-operatively, and at 3 and 6 months after surgery. Postoperative QOL differences were assessed using the Wilcoxon signed-rank test. A surgical probe, the Perc-DLE SpineWand, was placed percutaneously into the disc after application of a local anesthetic or induction of general anesthesia to remove part of the disc (that is, a percutaneous discectomy).<\/jats:p><jats:p>Nucleoplasty-treated levels were L2\u20133 (one case), L3\u20134 (five cases), L4\u20135 (44 cases), and L5\u2013S1 (40 cases); there were 22 multiple treatment levels and 42 bilateral treatments. There were no infections or nerve root injuries associated with the procedure. Compared with preoperative QOL, there was a statistically significant improvement in QOL at 3 months as measured using the SF-36 Physical Component Summary (PCS) scale (mean score improvement 4.4 [p = 0.014]), the EQ5D (mean score improvement 0.22 [p = 0.001]), and the VAS for pain (mean score improvement 0.13 [p = 0.02]). Six-month results in 36 patients continued to reflect improvement as measured using the SF-36 PCS (mean score improvement 7.6 [p = 0.002]) and the EQ5D (mean score improvement 0.27 [p = 0.001]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Nucleoplasty-based percutaneous disc decompression in patients with symptomatic contained disc herniations is safe and improves QOL as measured by the SF-36, EQ5D, and VAS for pain, three generic QOL outcome instruments. Nucleoplasty is an effective minimally invasive surgical treatment alternative in patients with symptomatic contained disc herniations. 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