PERCUTANEOUS NUCLEOPLASTY FOR THE TREATMENT OF SYMPTOMATIC INTERVERTEBRAL DISC PROTRUSIONS USING NAVIGABLE PLASMA COBLATION DEVICE

A. Zolovkins, G. Orgera, M. Doddi, S. Pulcinelli, E. Ronconi | Interventional Radiology Unit, Sant'Andrea Hospital, Sapienza University of Rome, Italy

Abstract

Background and Aims. The objective of this study is to evaluate the clinical efficacy and technical safety of percutaneous nucleoplasty using the navigable plasma coblation device (Yes Disc TSS Medical) for treating radicular pain caused by lumbar and cervical disc protrusion.
Methods. From January 2024 to January 2026, we treated thirty-eight patients with persistent pain for more than 6 months that was refractory to conservative or other minimally invasive treatments. Thirty-two patients had lumbar herniations (41 levels treated) and six patients had cervical protrusions (9 levels). The procedure of nucleoplasty is performed under local anesthesia and consists of percutaneous fluoro-guided insertion of a navigable probe in the nucleus pulposus and its coblation using plasma technology. In twenty-three cases of significant sciatica-type pain, neuromodulation with pulsed radiofrequency of the affected nerve root was added. Follow-up was conducted at 48 h, 1, 6, 12, and 24 months using the pain VAS score. Clinical success was considered to be a 50% reduction in pain.
Results. The mean VAS score decreased from 8.8 pre-procedure to 1.9 at 48 h, 1.5 at 1 and 6 months, 1.0 at 12 months and 1.7 at 24 months. The Oswestry Disability Index improved from 63% to 18% at 48 h, to 9% at 1, 6, and 12 months, and to 12% at 24 months. No complications were observed. Eighty-three percent of patients returned to work within 7 days. Better response was observed in patients with contained and focal protrusions. No reintervention at the same level was required.
Conclusions. Nucleoplasty using plasma coblation technology with a navigable probe of the Yes Disc device is safe, rapid, and minimally invasive, resulting in significant improvement in pain and function. Preliminary data indicate effectiveness in the management of symptomatic disc protrusions in selected patients.