Nucleoplasty (Lumbar / Cervical Spine) in Munich: Minimally Invasive Disc Treatment

Medical Basics

What is nucleoplasty?

Intervertebral discs consist of an outer fibrous ring (Anulus fibrosus) and a soft gel-like core (Nucleus pulposus). Wear or overstrain can lead to a disc protrusion or a small herniated disc, which may irritate or compress nerve structures.

Nucleoplasty is a minimally invasive thermal procedure in which a small portion of disc tissue is precisely liquefied and reduced using plasma energy (coblation) via a fine probe. This reduces pressure within the disc, which can relieve the affected nerve root.

Which structures are affected?

• Intervertebral discs of the lumbar spine (L-spine)
• Intervertebral discs of the cervical spine (C-spine)
• Adjacent nerve roots

Causes and Risk Factors

Disc changes for which nucleoplasty is considered often result from:

• Degenerative changes of the spine (age- or wear-related)
• Mechanical overload, e.g. from heavy lifting or prolonged sitting
• Repetitive strain in daily life or work
• Weak core and back muscles

Typical Symptoms

Symptoms arise from compression or irritation of nerve structures and may vary depending on location:

• Back pain radiating into the leg (e.g. sciatica)
• Neck pain radiating into the arm or shoulder
• Tingling or numbness
• Pain worsened by physical activity

Distinction

In cases of severe neurological deficits such as paralysis, large or sequestered disc herniations, or spinal instability, nucleoplasty is generally not suitable.

Diagnostics

At the Gromer Orthopedic Clinic in Munich, structured evaluation is carried out before nucleoplasty:

• Medical history: type, duration, and progression of symptoms
• Clinical-neurological examination
• Imaging, usually MRI for detailed disc assessment
• Review of previous treatments (physiotherapy, medication, infiltrations)

Treatment Options

Conservative

Before considering an interventional procedure, conservative treatments are typically exhausted, including:

• Physiotherapy and back training
• Medication-based pain management
• Infiltrations
• Adjustment of physical activity and daily routines

Nucleoplasty

Nucleoplasty is performed on an outpatient basis. Under X-ray guidance, a fine probe is precisely inserted into the affected disc. The procedure is done under short anesthesia and usually takes about 20 minutes. After brief observation, the patient can usually return home the same day.

Progress and Prognosis

Clinical observations report significant pain reduction in most suitable patients. Initial improvements may occur within a few weeks, often after about 4-6 weeks. Long-term stability depends in part on complementary training and muscle strengthening.

Aftercare

Aftercare following nucleoplasty depends on the treated spinal region (lumbar or cervical) and supports stabilization and controlled remobilization.

General Recommendations

• 2-3 days of physical rest, followed by gentle mobilization
• Physiotherapy from week 1-2 for targeted muscle strengthening
• Avoid heavy physical strain for about 4 weeks
• Follow-up appointment usually after 1 week
• Pain reduction typically within a few weeks, with first effects usually seen after 4-6 weeks

Region-Specific Aftercare

• Lumbar spine (L-spine): Wearing a lumbar support belt for about 10 days
• Cervical spine (C-spine): Wearing a soft cervical collar for 7-10 days

The exact duration of supportive bracing may vary depending on individual findings and the healing process, and is determined by the physician.

Conclusion

Nucleoplasty is a minimally invasive procedure for treating selected disc conditions in the cervical and lumbar spine. At the Gromer Orthopedic Clinic in Munich, it is considered a joint- and nerve-sparing option between conservative therapy and open surgery following thorough diagnostics.