In the past, the only therapeutic option left for these patients was surgical fusion, a procedure that limits motion and yields mixed results. The patient is mildly sedated and given a local anesthetic. Under X-ray guidance, a needle and special thermal catheter are inserted into the damaged disc. The catheter is heated to 90 degrees Celsius over 16.5 minutes. The thermal energy destroys the intradiscal nerve fibers and thickens the outer disc, closing the tiny fissures.
Patient selection is critical.
No radicular component. Normal neurologic examination. Preserved disc height of 50 percent or more. No evidence of compressive neural pathology. No evidence of segmental instability on standing lateral flexion and extension radiographs.