Percutaneous nucleotomy. An alternative to spinal surgery.

Area of Science:

• Neurosurgery
• Minimally Invasive Procedures

Background:

• Disk herniation treatment traditionally involves invasive surgical methods.
• Percutaneous nucleotomy presents a less invasive alternative.
• It is also an option when contrast agent leakage occurs during diskography, a risk in chemical nucleolysis.

Observation:

• The procedure involves removing nucleus pulposus via forceps through a cannula, reducing disk volume.
• It can be performed under local anesthesia.
• Contraindications include prolapse within or displacement beyond the spinal canal.

Findings:

• In a 1979-1985 study, 51 patients underwent percutaneous nucleotomy for herniation, often with spinal canal stenosis or spondylolisthesis.
• Clinical results were assessed as very good, good, or satisfactory in 32 out of 51 patients.
• A high proportion of good clinical results was observed, even with combined lumbar pathologies.

Implications:

• Percutaneous nucleotomy is a viable and effective treatment for disk herniation, especially when combined with other spinal conditions.
• It avoids complications associated with chemical nucleolysis, such as anaphylactic shock.
• The technique offers a bone-sparing and soft-tissue-preserving approach compared to traditional surgery.