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Miscellaneous Spine Procedures: Nucleoplasty, Intradiscal Electrothermal Therapy (IDET), and Cryotherapy

  • Vwaire OrhurhuEmail author
  • Christopher Aiudi
  • Ivan Urits
  • Jatinder S. Gill
Chapter

Abstract

Approximately 40% of low back pain is caused by intervertebral disc pathology. While surgery may be an effective treatment for patient refractory to conservative management, it may not reliably provide symptomatic relief and may be associated with significant morbidity. Minimally invasive procedures such as nucleoplasty, neuronal cryotherapy, and percutaneous intradiscal thermocoagulation have been demonstrated to be efficacious in the treatment of low back pain secondary to intervertebral disc pathology and offer a viable therapeutic modality prior to undergoing surgery. Nucleoplasty involves the use of a high energy source to mechanically remove the soft tissue that is attributed to the source of pathology causing pain. Cryotherapy employs cold temperatures to create an anesthetic block by inducing neurolysis of the nervous tissue innervating the painful area. Percutaneous intradiscal thermocoagulation provides pain relief by employing a heated probe to produce structurally advantageous changes to the intervertebral disc and concomitantly ablate nociceptive nerves of the pathological disc. Together, these minimally invasive options to treating low back pain that is secondary to pathology of the intervertebral disc may offer improved pain in function to otherwise surgical patients.

Keywords

Discogenic pain Plasma disc decompression and nucleoplasty Percutaneous intradiscal thermocoagulation IDET Cryotherapy Disc nucleoplasty Discography Cryoneurolysis 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Vwaire Orhurhu
    • 1
    Email author
  • Christopher Aiudi
    • 2
  • Ivan Urits
    • 1
  • Jatinder S. Gill
    • 1
  1. 1.Department of Anesthesia, Critical Care and Pain MedicineBeth Israel Deaconess Medical Center, Harvard Medical SchoolBostonUSA
  2. 2.Department of Anesthesia, Critical Care and Pain MedicineMassachusetts General Hospital, Harvard Medical SchoolBostonUSA

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