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Side Effects and Complications After Percutaneous Disc Decompression Using Coblation Technology

Bhagia, Sarjoo M. MD; Slipman, Curtis W. MD; Nirschl, Monica MD; Isaac, Zacharia MD; El-Abd, Omar MD; Sharps, Lewis S. MD; Garvin, Cyndi PhD

American Journal of Physical Medicine & Rehabilitation: January 2006 - Volume 85 - Issue 1 - p 6-13
doi: 10.1097/01.phm.0000184153.98344.a4
Research Article: Spine
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Bhagia SM, Slipman CW, Nirschl M, Isaac Z, El-Abd O, Sharps LS, Garvin C: Side effects and complications after percutaneous disc decompression using coblation technology. Am J Phys Med Rehabil 2006;85:6–13.

Objective: To report the short-term side effects and complications after percutaneous disc decompression utilizing coblation technology.

Design: Following institutional review board approval, consecutive patients who were to undergo percutaneous disc decompression using coblation technology (nucleoplasty) were prospectively enrolled. Patients were questioned preoperatively, postoperatively, and 24 hrs, 72 hrs, 1 wk, and 2 wks postprocedure by an independent reviewer regarding 17 possible symptom complications, which included bowel or bladder symptoms, muscle spasm, new pain, numbness/tingling or weakness, fevers/chills, rash/pruritus, headaches, nausea/vomiting, bleeding, and needle insertion site soreness. Statistical analysis was performed using Wilcoxon’s signed-rank test.

Results: A total of 53 patients enrolled, of whom four patients dropped out. Two patients had increased symptoms and opted for surgery. Two patients could not be contacted. The most common side effects at 24 hrs postprocedure was soreness at the needle insertion site (76%), new numbness and tingling (26%), increased intensity of preprocedure back pain (15%), and new areas of back pain (15%). At 2 wks, no patient had soreness at the needle insertion site or new areas of back pain; however, new numbness and tingling was present in 15% of patients. Two patients (4%) had increased intensity of preprocedure back pain. There were statistically significant reductions in visual analog scale score for back pain and leg pain (P < 0.05).

Conclusions: Based on this preliminary data, nucleoplasty seems to be associated with short-term increased pain at the needle insertion site and increased preprocedure back pain and tingling numbness but without other side effects.

From the Penn Spine Research Group (SMB, CWS, MN, ZI, OEA, LSS, CG); the Scoliosis and Spine Center, Miller Orthopaedic Clinic, Charlotte, North Carolina (SMB); the Penn Spine Center (CWS) and Department of Physical Medicine and Rehabilitation (CWS, MN), Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; the Spaulding Rehabilitation Hospital, Harvard University, Boston, Massachusetts (ZI, OEA); the Department of Orthopaedic Surgery, Bryn Mawr Hospital, Bryn Mawr, Pennsylvania (LSS); and UCEDD and the Department of Biostatistics, University of Florida, Gainsville, Florida (CG).

All correspondence and requests for reprints should be addressed to Curtis W. Slipman, MD, Penn Spine Center, Ground Floor, White Building, Hospital of University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104.

© 2006 Lippincott Williams & Wilkins, Inc.