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Jargon buster

Nucleoplasty

Injection treatment for back pain due to nerve root irritation due to disc problems.

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Neurosciences

Intradiscal Electrothermal Therapy (IDET) Nucleoplasty


IntroductionShow [+]Hide [-]

Intradiscal Electrothermal Therapy (IDET) Nucleoplasty is a special technique which will hopefully help to reduce the pain you are experiencing in your lower back.
 
This procedure is carried out in theatre but does not involve an operation or a general anaesthetic being performed under sedation.  You will not need to say overnight and can go home the same day.

Before your procedure Show [+]Hide [-]

Local anaesthetic will be used, so please have nothing to eat after 6am. If there is likely to be any delay you will be offered something to eat and drink.
 
Please tell the doctor if any of the following relates to you:

  • You are taking any medication
  • You take blood thinning medication
  • You have a history of bleeding disorder
  • You are allergic to iodine as this will be used to clean your back before the procedure
  • You have an infection as this may mean we have to delay the procedure until you are well 
     

During your procedureShow [+]Hide [-]

  • You will have a drip placed in a vein in your arm. This allows us to give you fluids, sedation and antibiotics. 
  • Using x-ray, the affected area of your spine will be located and an injection of local anaesthetic will be given to numb that area. This may sting for a few seconds. 
  • When the area is numb, the doctor will place a needle into the area using x-ray as a guide. Some people have described this as uncomfortable. 
  • The doctor will pass a tiny electrothermal catheter (tube) through the needle, confirm the position by x-ray and begin the treatment. 
  • The electrothermal catheter allows heat to be applied to the affected area for between 14 and 17 minutes. During this time you may feel the symptoms of your back pain. Tell the doctor how you are feeling as we are able to help control any pain you may be feeling.
  • When the catheter is removed at the end of the procedure a small dressing is applied and you will be able to rest in whatever position you find comfortable until you are ready to go home. This may be about four hours. You can eat and drink if you want to during this time. 
  • Please arrange for transport home as you will be advised not to drive for six weeks.

 

After your procedureShow [+]Hide [-]

  • For the first 7 to 10 days some people experience an increase in their back pain. You are advised to rest, use ice packs, pain medication and anti-inflammatory medication which will all help to relive your symptoms.
  • Please contact the staff on the ward to tell them if you experience any new symptoms such as fever, rash or numbness. 
  • Some people feel much better immediately following the procedure. If this is the case for you please be careful not to over-exert yourself. Avoid all lifting, bending or other activity for the first week following the procedure. 
  • Discuss with your doctor when you should return to work as this will depend on the type of work you do. 
  • In the few months following the procedure, the disc is healing. The amount of pain you experience should begin to reduce. 
  • You will be prescribed pain and anti-inflammatory medication. Continue to use ice packs once or twice a day for 10 to 15 minutes if you find this helps to ease your symptoms.
  • For the first month, avoid bending, twisting or heavy lifting. Avoid contact sports including running, biking, golf and tennis. Gentle sexual activity is fine.
  • Your doctor and physiotherapist will advise you about exercise and help you devise a programme of activity so that you can return to your usual level of fitness. Short, gentle walks are encouraged. In time, this may include sporting activities. Travel plans can be discussed with your doctor.
  • Please ask your doctor any questions at your follow up outpatient appointments. 
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