Disc biacuplasty , also known as percutaneous biacuplasty, is a minimally invasive medical procedure used to treat chronic low back pain resulting from a damaged or degenerated intervertebral disc.
During the procedure, a needle is inserted into the affected disc under X-ray guidance. Two small electrodes are then passed through the needle and into the disc. The electrodes heat up and destroy small nerve fibers within the disc that transmit pain signals to the brain.
By destroying these nerve fibers, disc biacuplasty can provide long-lasting pain relief without the need for more invasive procedures such as spinal surgery. It is often performed on an outpatient basis and patients typically experience little to no downtime after the procedure.
When is a disc biacuplasty used?
Disc biacuplasty is typically used to treat chronic low back pain caused by degenerative disc disease that has not responded to conservative treatments such as medication, physical therapy, and/or spinal injections.
Degenerative disc disease is a condition in which the discs in the spine begin to break down and lose their cushioning ability, often due to age-related wear and tear.
How does a biacuplasty work?
Disc biacuplasty is a minimally invasive medical procedure that is performed under X-ray guidance.
During the procedure, a needle is inserted into the affected disc, and two small electrodes are then passed through the needle and into the disc. The electrodes heat up and destroy small nerve fibers within the disc that transmit pain signals to the brain.
By destroying these nerve fibers, disc biacuplasty can provide long-lasting pain relief without the need for more invasive procedures such as spinal surgery. The procedure can be performed on an outpatient basis and patients typically experience little to no downtime after the procedure.
What to expect during the procedure
During a disc biacuplasty procedure, the following steps are typically taken:
- Preparation: The patient is positioned on an X-ray table and given local anesthesia to numb the skin and surrounding tissue.
- Needle insertion: A needle is inserted into the affected disc under X-ray guidance to ensure proper placement.
- Electrode insertion: Two small electrodes are inserted through the needle and into the disc. These electrodes will deliver radiofrequency energy to destroy the nerve fibers responsible for transmitting pain signals from the disc.
- Confirmation of placement: The healthcare provider will use X-ray guidance to confirm the placement of the electrodes within the disc.
- Nerve destruction: The electrodes are heated to a specific temperature, which destroys the targeted nerve fibers within the disc.
- Completion of the procedure: Once the nerve destruction is complete, the electrodes are removed, and a small bandage is placed over the insertion site.
The entire procedure usually takes about 30 to 60 minutes to complete, and patients can typically return home the same day.
After the procedure, patients may experience some mild discomfort or soreness at the insertion site, but this can usually be managed with over-the-counter pain medication.
What is the recovery time after a biacuplasty?
In general, most patients are able to return to their normal activities within a few days to a week after the procedure.
Patients may experience some mild discomfort or soreness at the insertion site for a few days after the procedure, but this can usually be managed with over-the-counter pain medication such as NSAIDs.
Patients will typically be instructed to avoid heavy lifting or strenuous activities for a short period of time after the procedure to allow the insertion site to heal properly.
When can I return to work?
The length of time it takes to return to work after a disc biacuplasty procedure can vary depending on several factors, such as the type of work you do and the extent of your job responsibilities.
In general, patients may need to take a few days off from work to rest and recover after the procedure.
If your job requires physical activity or heavy lifting, your healthcare provider may recommend a longer period of rest and restriction of these activities after the procedure.
How long does it take to work?
The timeframe for when a disc biacuplasty procedure starts to provide pain relief can vary among patients. Some patients may experience immediate relief, while others may experience a gradual reduction in pain over several weeks following the procedure.
How long does pain relief last?
Pain relief from a biacuplasty lasts several months to several years. Some patients report permanent pain relief.
What are the risks of biacuplasty?
Like all medical procedures, disc biacuplasty carries some potential risks and complications. Some of the possible risks associated with the procedure include:
- Bleeding or bruising at the insertion site.
- Infection at the insertion site.
- Nerve damage or injury, which can cause numbness, weakness, or other neurological symptoms.
It is important for patients to discuss the potential risks and benefits of the procedure with their healthcare provider prior to undergoing the procedure. Patients should also follow all pre-procedure and post-procedure instructions carefully to minimize the risk of complications and to ensure the best possible outcome.
Does disc biacuplasties work?
Disc biacuplasty is a relatively new procedure, and while there is some evidence to support its use, more research is needed to determine its long-term effectiveness and safety.
Several small studies have shown that the procedure can provide significant pain relief for patients with discogenic pain (Desai 2016), although the duration of pain relief can vary.
The North American Spine Society (NASS), has concluded that “Biacuplasty is an option to produce clinically and statistically significant improvements in pain at 6 months in patients with discogenic low back pain”
Is a disc biacuplasty right for me?
Determining whether disc biacuplasty is right for you depends on several factors, including the cause and severity of your chronic low back pain, your medical history, and your overall health.
The decision to undergo any medical procedure should be made in consultation with your healthcare provider, who can evaluate your specific condition and recommend the most appropriate treatment options.
Your healthcare provider may recommend disc biacuplasty if other conservative treatments have not provided sufficient pain relief and if you meet certain eligibility criteria.
References
Desai, Mehul J et al. “A Prospective, Randomized, Multicenter, Open-label Clinical Trial Comparing Intradiscal Biacuplasty to Conventional Medical Management for Discogenic Lumbar Back Pain.” Spine vol. 41,13 (2016): 1065-1074. doi:10.1097/BRS.0000000000001412
Kreiner, D Scott et al. “Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of low back pain.” The spine journal : official journal of the North American Spine Society vol. 20,7 (2020): 998-1024. doi:10.1016/j.spinee.2020.04.006
