New Procedure Treats Herniated Disks

For Mary Texira, two years of sleepless nights are now a thing of the past, thanks to a new treatment for herniated discs at Bridgeport Hospital. The procedure, called nucleoplasty, enables physicians to quickly and efficiently remove pain-causing tissue rubbing against nerves, while using heat to seal incisions at the same time.

“It was torture,” Ms Texira, a 45-year-old former school bus driver and mother of two, says about her back pain. “I couldn’t sleep for more than an hour-and-a-half at night, and during the day, the pain was so bad, I could barely move. I feel a heck of a lot better now.”

Many people recover from back problems resulting from herniated discs quickly, aided by rest, therapeutic exercise or medication.

“For some, however, back problems are prolonged and severe, and do not respond to conventional treatments,” explained Dr Lawrence Kirschenbaum, the Bridgeport Hospital pain management specialist who treated Ms Texira. “Before nucleoplasty, the only option for these patients was radical surgery to remove part or all of the disc.”

Herniated discs are caused when the soft tissue between bones in the spine presses on the nerves around the backbone. The word “herniate” means to bulge or to stick out. Sometimes this is called a ruptured disc.

Herniated discs are most common in the lumbar spine, the part of the backbone between the bottom of the ribs and the hips. Discs are soft “cushions” between the bones of the spine. The discs in the spine allow the backbone to move.

Herniated discs are most common in people in their 30s and 40s. As people grow older, their discs become flatter and less elastic. If a disc becomes too weak, the outer part may tear. The inside part of the disc pushes through the tear and presses on the nerves beside it. When part of a disc presses on a nerve, it can cause pain in both the back and the legs. The location of the pain depends on which disc is weak. How bad the pain is depends on how much of the disc is pressing on the nerve.

Nucleoplasty is usually performed on an outpatient basis and usually takes less than an hour, says Dr Kirschenbaum. Local anesthesia and mild sedation may be used to reduce discomfort. Patients remain awake to provide important feedback to the physician.

“I felt absolutely no pain during the procedure,” Ms Texira said. Under x-ray guidance, the physician places an access needle into the disc. A special wand-like device is then inserted through the needle and into the disc. Tissue is removed as the device advances into the disc. This creates a small channel.

The device is then slowly withdrawn to its original position while sealing the channel with heat energy. Throughout the procedure, the physician closely monitors the patient’s condition and comfort level.

Several channels may be created, depending on the amount of tissue to be removed. At the end of the procedure, the wand and needle are removed. A small surgical dressing is placed over the needle insertion site, and patients rest until they are ready to go home.

Patients continue their recovery at home and are usually instructed to limited physical activity for several days. The physician may prescribe mild pain medication, and provide activity and physical rehabilitation guidelines.

“I’m a totally different person now,” Ms Texira said. “The procedure changed my life. If I ever have a disc problem again, I’ll go right back to Bridgeport Hospital for help.”