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The SpineWand surgical devices use Coblation technology to remove nucleus pulposis tissue. This removal of tissue at relatively low temperatures (typically 40-70 degrees ºC) preserves the integrity of surrounding healthy tissue while decompressing the disc.
The procedure is performed under fluoroscopic guidance with the patient placed in a prone position for the lumbar procedure or a supine position for the cervical procedure. Patients are often sedated at the discretion of the physician.
Appropriate sterile technique is observed.
Patient Selection Criteria
- Radicular symptoms > Axial symptoms
- Radiologic evidence of contained disc protrusion
- Discography concordant, if indicated
- Failed conservative treatment
- Disc height > 50%
- Discography positive for concordant pain
- Disc height > 75%
- Failed conservative treatment
- Spinal fracture or tumor
- Extruded disc
- Complete annular disruption
- Moderate to severe spinal stenosis
- Severe degenerative disc
- Bone deformities
Nucleoplasty is recommended for patients who have not responded to rest, medical intervention (including steroid injection), and/or physical therapy. The ideal nucleoplasty patient has symptoms associated with a contained herniated disc.
Radicular Symptoms:
Axial Symptoms (due to a contained disc herniation):
Contraindications:
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