and general symptoms were as follows: results were ex- pressed ‘excellent’ or ‘good’ in 17 patients (76%), ‘fair’ in 3 (14%), ‘poor’ in 1 (5%), and ‘worse’ in 1 patient (5%). Therefore, most patients satisfied with the clinical results (Fig. 3). The patients not satisfied with the clinical results were all patients who had discs treated on more than 2 disc levels. However, from the 6 patients who had been treated on only 1 level, 3 patients expressed ‘excellent’ and the other 3 graded their clinical improvement as ‘good’. Two months after the procedure, an MRI study was carried out in 2 pa- tients who had shown clinical improvement. In one of them, there was significant reduction of protruded disc material, while in the other it was not significant (Fig. 4, 5). DISCUSSION Nucleoplasty is a percutaneous disc decompression using radiofrequency energy. Bipolar radiofrequency coag- ulation denaturalizes proteoglycan and changes the in- SE Sim, et al / Nucleoplasty in Cervical Disc Disorder 41 ternal environment of the diseased nucleus pulposus; es- pecially, the organic molecules (collagen and collagen like long chain molecules) inside the disc is changed to liquid or gaseous state, which is absorbed and removed at the target site [2]. Chen et al. proved that the decompression using CoblationⓇ technique decreased the pressure in the disc with an experiment in a cadaveric specimen [6]. The advantage of the CoblationⓇ technique used in nucleo- plasty is that exceptionally precise and targeted removal is possible while minimizing the thermal injury to the sur- rounding tissue [7]. In proceeding with cervical nucleoplasty, the selection of a suitable patient is the most important. When Birnbaum’s recommendations [8] and indications of lumbar nucleoplasty are considered, they are as follows [5,9,10]: 1) In the case of lateral herniation, presence of rad- icular/axial pain while arm pain is severe than neck pain, MRI evidence of contained herniation, and failure of con- servative treatment. 2) In the case of central herniation, Fig. 5. Pre- and post-nucle- oplasty Magnetic Resonance Imaging for a 65-year-old woman. Preoperative sagittal (A) and axial (B) images show the disc protrusion causing right neural for a- minal stenosis at C6-7 inter- vertebral disc level. Post- operative sagittal (C) and axial (D) images do not show the evident volume reduction of protruded intervertebral disc segment.