الفهرس 
Anatomical considerationsof theOnly 14 pages are availabe for public view
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Abstract
Percutaneous procedures are minimally invasive, done percutaneously, under local anesthesia, having a very short procedure time and require only a short hospital stay, so the patient can return to normal daily activities in just a few days.
These techniques also eliminate the risks of postoperative scarring related to surgery which are often responsible for recurrence of pain.
The interventional percutaneous procedures include chemonucleolysis, automated percutaneous lumbar discectomy, intradiscal laser discectomy, intradiscal electrothermal therapy, and most recently percutaneous coblation discectomy.
Percutaneous coblation discectomy uses radiofrequency (RF) energy to ablate the nucleus pulposus in a controlled manner for disc decompression in a process referred to as coblation technology, during the procedure the nucleoplasty spine wand is introduced via a needle and placed into the centre of the disc where series of channels are created to remove tissue from the nucleus. The technique is relatively safe and the outcomes are encouraging.
Aim of this work is to evaluate the efficacy of coblation discectomy technique in patients with lumbar disc lesions (bulge, protrusion and contained herniations) with radicular leg pain.
The disc puncture is performed with a posterolateral approach, under fluoroscopic guidance. Under local anesthesia and complete aseptic condition the Spine Wand is introduced to create Six channels in the substance of the nucleus which are sufficient to decrease the nucleus volume by 1 cc = 10%.
This study has included 40 patients (55 disc levels); their age is ranged from 25 to 59. 23 of them are females while 17 are males.
All patients were complaining of low back pain with leg radiculopathy, not responding to conservative measures for at least 3 months.
All procedures were considered technically successful, the complications associated with the procedure and during the follow-up periods were 9 cases with increased pain during the procedure, one case Discitis, one case nerve root irritation, and one case have operated upon with discectomy within 12 months after the procedure and 28 cases with no complications.
Assessment of the patients was carried out pre-procedure, and at two weeks, three months, six months and one year post-procedure. Assessment data has been collected in each visit including Visual Analogue Scale (VAS), Oswestry Disability Index Questionnaire (ODI), reduction in analgesic treatment, patients’ satisfaction and any complications has recorded.
There was complete resolution of symptoms in 28 (70%) at the latest follow-up who were either satisfied or very satisfied, while 12 (30%) had no resolution at the latest follow-up. one patients had to be operated after nucleoplasty because of severe pain continuing despite technically successful procedures.