Advanced Nucleoplasty and Annuloplasty for Back Pain Relief
This page covers minimally invasive disc procedures, specifically nucleoplasty and annuloplasty, for disc-related neck and back pain.
Who May Benefit?
Discogenic Pain
Intervertebral discs act as cushions between the bones of the spine. When a disc becomes damaged or degenerative, it can bulge or herniate, causing local back or neck pain and sometimes radiating pain into the arms or legs. In many patients, symptoms improve with time, physiotherapy, and medications. However, some continue to experience significant pain despite conservative treatment.
For these patients, minimally invasive disc procedures such as nucleoplasty and annuloplasty may be considered. These techniques are typically offered to patients with contained disc protrusions or annular tears, where imaging and clinical assessment suggest that the disc is a major source of pain
Disc procedures such as nucleoplasty and annuloplasty are minimally invasive treatments for patients with persistent neck or back pain arising from damaged intervertebral discs. These techniques aim to reduce disc pressure, stabilise the disc wall, and relieve nerve irritation, without the need for open surgery in carefully selected cases.
Nucleoplasty is a minimally invasive procedure that targets the soft inner portion of the disc (the nucleus pulposus). Under image guidance, a specialised needle is placed into the centre of the affected disc. Through this needle, a small device is introduced to remove or shrink a controlled amount of disc material using radiofrequency energy or a similar technology.
By reducing the volume and pressure within the disc, nucleoplasty aims to decrease the bulge and relieve pressure on nearby nerve roots. This can help reduce both local back or neck pain and radiating leg or arm pain in appropriately selected patients.
An annular tear occurs when there is damage or a rupture the annulus fibrosus. Annular tears are commonly associated with degenerative changes in the spine, traumatic injuries, or repetitive stress over time. These tears can cause back pain by irritation of nerves supplying the annulus fibrosus, Inflammation and Loss of disc function.
In this procedure, needles are placed in the intervertebral discs and heat is applied across the discs. (See image above) This procedure helps to denervate the disc and interrupt the barrage of pain signals entering the brain during activity. It can also help to seal up the annular tear in a significant proportion of patients who undergo this procedure.
Nucleoplasty and annuloplasty are usually performed as day procedures under local anaesthesia with sedation or light general anaesthesia, depending on your clinical needs. Most patients are able to walk on the same day and return home after a period of observation. Some temporary soreness at the needle entry site or a transient increase in back pain can occur and usually settles over several days. After the procedure, you will need to minimize twisting and bending for a few weeks to allow healing to take place.
As with all spine procedures, there are potential risks, including infection, bleeding, nerve irritation, or worsening of symptoms. Serious complications are uncommon when the procedures are performed by an experienced specialist using strict sterile technique and image guidance. Pain relief may be gradual over several weeks as inflammation settles and the disc adapts.
Spine Assessment with Dr Christopher Liu
Dr Christopher Liu is a pain management specialist in Singapore offering expert assessment and minimally invasive disc procedures, such as nucleoplasty and annuloplasty, where appropriate. Every patient receives a personalized plan tailored to their specific spinal condition.
Contact us directly at +65 86555722