Disc biacuplasty

From WikiMD's medical encyclopedia

Disc biacuplasty is a minimally invasive surgical procedure aimed at treating back pain associated with discogenic pain originating from the intervertebral discs. This procedure is particularly focused on patients who have not responded to conservative treatments such as physical therapy, medications, or epidural steroid injections. Disc biacuplasty utilizes controlled thermal energy to desensitize and modify the nerve fibers within the affected disc, thereby reducing pain.

Overview

Disc biacuplasty involves the insertion of two needle-like probes into the affected intervertebral disc under fluoroscopic guidance. These probes are placed on either side of the disc, and once correctly positioned, they generate a field of thermal energy that disrupts the pain fibers without causing significant damage to the disc structure. The procedure is typically performed on an outpatient basis, allowing patients to return home the same day.

Indications

Disc biacuplasty is indicated for patients with chronic lumbar discogenic pain who have not found relief from non-surgical treatment modalities. Ideal candidates are those with confirmed discogenic pain, usually identified through magnetic resonance imaging (MRI) or discography, and without significant disc herniation or degeneration that would necessitate more invasive surgical intervention.

Procedure

The procedure is carried out under local anesthesia with sedation. The patient lies face down, and the skin over the treatment area is sterilized and numbed. Using fluoroscopic guidance, the physician inserts two special needles (biacuplasty probes) into the disc from both sides. Once in place, the probes generate radiofrequency energy for a specific period, usually around 90 seconds, creating a thermal field that disrupts the pain-causing nerves within the disc.

Benefits

Disc biacuplasty offers several benefits over traditional surgical approaches, including:

  • Minimally invasive with smaller incisions
  • Reduced risk of infection and complications
  • Shorter recovery time
  • Preservation of disc integrity
  • Outpatient procedure

Risks and Complications

As with any medical procedure, disc biacuplasty carries potential risks and complications, which may include:

  • Infection
  • Bleeding
  • Nerve damage
  • No relief or worsening of pain
  • Disc damage

Recovery

Post-procedure, patients may experience temporary soreness or discomfort at the needle insertion sites. Most patients can resume light activities within a few days, but a full return to normal activities may take several weeks. Physical therapy may be recommended to strengthen the back muscles and support the spine.

Effectiveness

Studies on disc biacuplasty have shown it to be an effective treatment for reducing chronic discogenic pain in the short to medium term. However, long-term outcomes and comparisons with other treatments are still under investigation.

Conclusion

Disc biacuplasty represents a promising treatment option for patients suffering from chronic discogenic back pain, offering a minimally invasive alternative to more extensive surgery. As with any medical procedure, patients should consult with a healthcare professional to determine if disc biacuplasty is the right option for their condition.


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Contributors: Prab R. Tumpati, MD