more to the estimated lesion site. Here, it should not go past the imaginary line beyond that connects the posterior vertebral bodies in lateral view (Fig. 1). Next, the PercTM DC Spine WandTM was connected to the ArthroCare system 2000Ⓡ (ArthroCare Co., Sunnyvale, CA, USA), and coagu- lation was tested with the radio-frequency controller set at 2′for 1-2 seconds to check that there was no movement or paresthesia in the patient’s upper limbs. CoblationⓇ was then carried out to remove the nucleus pulposus. By rotat- ing the flange 180o, we ablated the disc material - de- pending on the size and hardness of the lesion - for 20-60 seconds with the radio-frequency controller set at 2′-3′ of intensity. After this, the wand was slightly retreated under the C-arm fluoroscope guidance, and coagulation proceeded with controller set at 3 ′.When it was verified that there was no movement or paresthesia in the pa- tient’s upper extremities, the flange was rotated 180o and ablation was done for 20-60 seconds with controller set at 3′or 4 ′.If the patient complained of abnormal pain dur- ing the ablation, the needle tip was slightly retreated and started from coagulation stage again to check nerve stimulation. The number of voids, duration and intensity of ablation were adjusted to the size and hardness of the protruded disc material. After the procedure, the patient took an absolute bed rest in the supine position for 4 hours. And an intravenous injection of 1.0 g of cefazolin was administered again as a prophylactic antibiotic. Six hours after the procedure, systemic symptoms were Table 1. Demographic Data of Patients Age (yrs) Sex (M/F) Main symptom Axial pain only Axial pain < Radicular pain Axial pain = Radicular pain Preoperative MRI findings Protrusion Extrusion Stenosis Levels treated (1 level/2 levels/3 levels) C3-4 C4-5 C5-6 C6-7 Data for age are expressed as mean ± SD. Data 47.8 ± 11.9 15/7 4 9 9 17 2 3 6/8/8 6 12 14 14 SE Sim, et al / Nucleoplasty in Cervical Disc Disorder 39 checked and neurological examination was performed to make sure there were no abnormalities. When the patients’ status improved, they were discharged home with the in- structions outlining post-surgery precautions and contact numbers for any enquiries that they might have. Patients visited the outpatient clinic 1 month and 6 months post-op for observation. 3. Patient assessment Clinical improvement after nucleoplasty was assessed with a VAS (visual analogue scale) recorded at pre- procedure, postprocedure 1 month, and 6 months. Overall patient satisfaction on clinical outcome was defined ‘excellent’, ‘good’, ‘fair’, ‘poor’, or ‘worse’ according to the Modified MacNab criteria. Follow up MRI examination were not performed in all patients due to financial problems. Postprocedure MRI examinations were per- formed at the 2 months follow up in only 2 patients who did show clinical improvement. The statistical analyses were performed using PASW (PASW Statistics 17.0, SPSS Inc., Chicago, IL, USA). The individual data are expressed as mean ± SD. The Wilcoxon signed rank test was used to compare results of nucleo- plasty at preprocedure, postprocedure 1 month, and 6 months. The level of statistical significance was set at P ＜ 0.05. RESULTS Of the 22 patients, the gender distribution was 15 male and 7 female. The age of patients ranged from 19 to 71 Fig. 2. Pain intensity at the baseline and 1, 6 months of a follow-up period after the cervical nucleoplasty. Mean ± C.I (Confidence interval). P ＜ 0.05.