Clinical Guidance

Clinical Evidence, Meta Analysis, and Systematic Evidence Reviews

Preclinical Evidence

Scientific Evidence

Clinical Guidance

NICE — National Institute for Health and Care Excellence. Percutaneous coblation of the intervertebral disc for low back pain and sciatica: Interventional procedures guidance. Published: 27 January 2016. Guidance ipg543. ISBN: 978-14731-1632-0 https://www.nice.org.uk/guidance/ipg543/resources/percutaneous-coblation-of-the-intervertebraldisc-for-low-back-pain-and-sciatica-pdf-1899871925113285

Clinical Evidence, Meta Analysis, and Systematic Evidence Reviews

Eichen PM, Achilles N, König V, Mösges R, Hellmich M, Himpe B, Kirchner R. Nucleoplasty, a Minimally Invasive
Procedure for Disc Decompression: A Systematic Review and Meta-analysis of Published Clinical Studies. Pain Physician, 2014; 17: E149-E173. ISSN 2150-1149. PMID: 24658486 https://pubmed.ncbi.nlm.nih.gov/24658486/

Gerszten PC, Smuck M, Rathmell JP, Simopoulos TT, Bhagia SM, Mocek CK, Crabtree T, Bloch DA, SPINE Study Group. Plasma disc decompression compared with fluoroscopy-guided transforaminal epidural steroid injections for symptomatic contained lumbar disc herniation: a prospective, randomized, controlled trial. Journal of Neurosurgery, Volume 12: Issue 4 (Apr 2010). DOI: 10.3171/2009.10.SPINE09208. PMID: 20201654 https://pubmed.ncbi.nlm.nih.gov/20201654/

Cesaroni A, Nardi PV. Plasma disc decompression for contained cervical disc herniation: a randomized, controlled trial. European Spine Journal, (2010) 19: 477–486. DOI 10.1007/s00586-009-1189-0. PMCID: PMC2899766. PMID: 19902277 https://pubmed.ncbi.nlm.nih.gov/19902277/

Nardi PV, Cabezas D, Cesaroni A. Percutaneous cervical nucleoplasty using coblation technology. Clinical results in fifty consecutive cases. Acta Neurochir, (2005) [Suppl] 92: 73–78. DOI: 10.1007/3-211-27458-8_16. PMID: 15830972 https://pubmed.ncbi.nlm.nih.gov/15830972/

Stronks D, Huygen F, Groeneweg G, Aukes H, Harhangi B, de Rooij J. The Effect of Percutaneous Nucleoplasty vs Anterior Discectomy in Patients with Cervical Radicular Pain due to a Single-Level Contained Soft-Disc Herniation: A Randomized Controlled Trial. Pain Physician, 2020 Nov; 23(6): 553-564. PMID: 33185372 https://pubmed.ncbi.nlm.nih.gov/33185372/

Nikoobakht M, Yekanineajd MS, Pakpour AH, Gerszten PC, Kasch R. Plasma disc decompression compared to physiotherapy for symptomatic contained lumbar disc herniation: A prospective randomized controlled trial. Neurologia i Neurochirurgia Polska, Volume 50, Issue 1, January–February 2016, Pages 24-30. DOI: 10.1016/j.pjnns.2015.11.001. PMID: 26851686 https://pubmed.ncbi.nlm.nih.gov/26851686/

Chitragran R, Sompob P, Tassanawipas W. Result of Percutaneous Disc Decompression Using Nucleoplasty in Thailand: A Randomized Controlled Trial. J Med Assoc Thai, 2012 Oct; 95 Suppl 10: S198-205. PMID: 23451463 https://pubmed.ncbi.nlm.nih.gov/23451463/

Manchikanti L, Falco FJE, Benyamin RM, Caraway DL, Deer TR, Singh V, Hameed H, Hirsch JA. An update of the systematic assessment of mechanical lumbar disc decompression with nucleoplasty. Pain Physician, 2013 Apr; 16(2 Suppl): SE25-54. PMID: 23615886 https://pubmed.ncbi.nlm.nih.gov/23615886/

Wullems JA, Halim W, van der Weegen W, Lim T, Aukes HA, Vissers KC, Gültuna I, Chua NHL. The Long-term Efficacy and Safety of Percutaneous Cervical Nucleoplasty in Patients with a Contained Herniated Disk. Pain Pract, 2013 Jun; 13(5): 364- 71. Epub 2012 Oct 31. DOI: 10.1111/papr.12003. PMID: 23113964 https://pubmed.ncbi.nlm.nih.gov/23113964/

Gerges FJ, Lipsitz SR, Nedeljkovic SS. A systematic review on the effectiveness of the Nucleoplasty procedure for discogenic pain. Pain Physician, Mar-Apr 2010; 13(2): 117-32. PMID: 20309378 https://pubmed.ncbi.nlm.nih.gov/20309378/

Wullems JA, Halim W, van der Weegen W. Current evidence of percutaneous nucleoplasty for the cervical herniated disk: a systematic review. Pain Pract, 2014 Jul; 14(6): 559-69. Epub 2013 Oct 17. DOI: 10.1111/papr.12122. PMID: 24131742 https://pubmed.ncbi.nlm.nih.gov/24131742/

Alexandre A, Coro L, Azuelos A, Pellone M. Percutaneous nucleoplasty for discoradicular conflict. Acta Neurochir Suppl, 2005; 92:83-6. DOI: 10.1007/3-211-27458-8_18. PMID: 15830974 https://pubmed.ncbi.nlm.nih.gov/15830974/

Gelalis I, Gkiatas I, Spiliotis A, Papadopoulos D, Pakos E, Vekris M, Korompilias A. Current Concepts in Intradiscal Percutaneous Minimally Invasive Procedures for Chronic Low Back Pain. Asian J Neurosurg, Jul-Sep 2019; 14(3): 657-669. PMCID: PMC6703031. DOI: 10.4103/ajns.AJNS_119_17. PMID: 31497082 https://pubmed.ncbi.nlm.nih.gov/31497082/

Wu S, Li X, Lin C, Zeng W, Ma C. CT-guided nucleoplasty with radiofrequency energy for the treatment of lumbar disk herniation. J Spinal Disord Tech, 2015 Feb; 28(1): E9-16. DOI: 10.1097/BSD.0000000000000132. PMID: 25023711 https://pubmed.ncbi.nlm.nih.gov/25023711/

Sinan T, Sheikh M, Buric J, Dashti K, Al-Mukhaimi A. Percutaneous coblation nucleoplasty in patients with contained lumbar disc prolapse: 1 year follow-up in a prospective case series. Acta Neurochir Suppl, 2011; 108: 107-12. DOI: 10.1007/978-3-211-99370-5_16. PMID: 21107945 https://pubmed.ncbi.nlm.nih.gov/21107945/

Birnbaum K. Percutaneous cervical disc decompression. Surg Radiol Anat, 2009 Jun; 31(5): 379-87. DOI: 10.1007/ s00276-009-0462-6. Epub 2009 Feb 4. DOI: 10.1007/s00276-009-0462-6gh. PMID: 19190848 https://pubmed.ncbi.nlm.nih.gov/19190848/

Saeid Abrishamkar S, Kouchakzadeh M, Mirhosseini A, Tabesh H, Rezvani M, Moayednia A, Ganjeifar B, Mahabadi A, Yousefi E, Kooshki AM. Comparison of open surgical discectomy versus plasma-laser nucleoplasty in patients with single lumbar disc herniation. J Res Med Sci, 2015 Dec; 20(12): 1133-7. PMCID: PMC4766818. DOI: 10.4103/1735- 1995.172979. PMID: 26958046 https://pubmed.ncbi.nlm.nih.gov/26958046/

Luleci N, Dere K, Akbas M, Abdulkarimov V, Luleci E. Effectiveness comparison of nucleoplasty and automatic percutaneous lumbal discectomy procedures in pain and disability scores for herniated lumbar discs. Turkiye Klinikleri J Med Sci, 2010; 30(1): 201-6. DOI: 10.5336/medsci.2008-9523 https://www.turkiyeklinikleri.com/article/eneffectiveness-comparison-of-nucleoplasty-and-automatic-percutaneous-lumbal-discectomy-procedures-in-painand-disability-scores-for-herniated-lumbar-discs-57254.html

Bokov A, Skorodumov A, Isrelov A, Stupak Y, Kukarin A. Differential treatment of nerve root compression pain caused by lumbar disc herniation applying nucleoplasty. Pain Physician, Sep-Oct 2010; 13(5): 469-80. PMID: 20859316 https://pubmed.ncbi.nlm.nih.gov/20859316/

Karaman H, Tüfek A, Kavak G O, Yildirim Z B, Temel V, Çelik F, Akdemir M S, Kaya S. Effectiveness of nucleoplasty applied for chronic radicular pain. PMID: 21804466. Med Sci Monit, 2011 Aug; 17(8): CR461-466. PMID: 21804466 https://pubmed.ncbi.nlm.nih.gov/21804466/

Gerszten PC, Welch WC, King Jr JT. Quality of life assessment in patients undergoing nucleoplasty-based percutaneous discectomy. J Neurosurg Spine, 2006 Jan; 4(1): 36-42. DOI: 10.3171/spi.2006.4.1.36. DOI: 10.3171/spi.2006.4.1.36. PMID: 16506464 https://pubmed.ncbi.nlm.nih.gov/16506464/

Al-Zain F, Lemcke J, Killeen T, Meier U, Eisenschenk A. Minimally invasive spinal surgery using nucleoplasty: a 1-year follow-up study. Acta Neurochir (Wien), 2008 Dec; 150(12): 1257-62. DOI: 10.1007/s00701-008-0150-z. PMID: 19023515 https://pubmed.ncbi.nlm.nih.gov/19023515/

Adam D, Pevzner E, Gepstein R. Comparison of Percutaneous Nucleoplasty and Open Discectomy in Patients with Lumbar Disc Protrusions. Chirurgia (Bucur), Jan-Feb 2013; 108(1): 94-8. PMID: 23464777 https://pubmed.ncbi.nlm.nih.gov/23464777/

Halim W, van der Weegen W, Lim T, Wullems JA, Vissers KC. Percutaneous Cervical Nucleoplasty vs. Pulsed Radio Frequency of the Dorsal Root Ganglion in Patients with Contained Cervical Disk Herniation; A Prospective, Randomized Controlled Trial. Pain Pract, 2017 Jul; 17(6): 729-737. DOI: 10.1111/papr.12517. Epub 2016 Oct 14. PMID: 27611826 https://pubmed.ncbi.nlm.nih.gov/27611826/

LS Sharps, Z Isaac. Percutaneous disc decompression using nucleoplasty. Pain Physician, 2002 Apr; 5(2): 121-6. PMID: 16902662 https://pubmed.ncbi.nlm.nih.gov/16902662/

Singh V, Piryani C, Liao K. Evaluation of percutaneous disc decompression using coblation in chronic back pain with or without leg pain. Pain Physician, 2003 Jul; 6(3): 273-80. PMID: 16880871 https://pubmed.ncbi.nlm.nih.gov/16880871/

Shabat S, David R, Folman Y. Nucleoplasty is effective in reducing both mechanical and radicular low back pain: a prospective study in 87 patients. J Spinal Disord Tech, 2012 Aug; 25(6): 329-32. DOI: 10.1097/BSD.0b013e318220dbe9. DOI: 10.1097/BSD.0b013e318220dbe9. PMID: 22124428 https://pubmed.ncbi.nlm.nih.gov/22124428/

Masala S, Massari F, Fabiano S, Ursone A, Fiori R, Pastore F, Simonetti G. Nucleoplasty in the treatment of lumbar diskogenic back pain: one year follow-up. Cardiovasc Intervent Radiol, May-Jun 2007; 30(3): 426-32. DOI: 10.1007/ s00270-006-0223-4. DOI: 10.1007/s00270-006-0223-4. PMID: 17278033 https://pubmed.ncbi.nlm.nih.gov/17278033

Mirzai H, Tekin I, Yaman O, Bursali A. The results of nucleoplasty in patients with lumbar herniated disc: a prospective clinical study of 52 consecutive patients. Spine J, Jan-Feb 2007; 7(1): 88-92; discussion 92-3. DOI: 10.1016/j. spinee.2006.02.033. Epub 2006 Nov 20. PMID: 17197339 https://pubmed.ncbi.nlm.nih.gov/17197339/

Kallás JL, Godoy BL, Andraus CF, de Carvalho FG, Andraus MEC. Nucleoplasty as a therapeutic option for lumbar disc degeneration related pain: a retrospective study of 396 cases. Arq Neuropsiquiatr, 2013 Jan; 71(1): 46-50. DOI: 10.1590/ s0004-282×2012005000013. Epub 2012 Dec 18. PMID: 23249972 https://pubmed.ncbi.nlm.nih.gov/23249972/

Singh V, Piryani C, Liao K. Role of percutaneous disc decompression using coblation in managing chronic discogenic low back pain: a prospective, observational study. Pain Physician, 2004 Oct; 7(4): 419-25. PMID: 16858482 https://pubmed.ncbi.nlm.nih.gov/16858482/

Li S, Chen R, Chen Y, Mo G, Zhang L, Xie P, Wang Q, Liu B, Dong J, Rong L. Therapeutic Effects and Safety of Percutaneous Disc Decompression with Coblation Nucleoplasty in Cervical Vertigo: A Retrospective Outcome Study with 74 Consecutive Patients and Minimum 1-Year Follow-Up. Pain Physician, 2019 May; 22(3): E205-E214. PMID: 31151343 https://pubmed.ncbi.nlm.nih.gov/31151343/

Bonaldi G, Baruzzi F, Facchinetti A, Fachinetti P, Lunghi S. Plasma Radio-Frequency–Based Diskectomy for Treatment of Cervical Herniated Nucleus Pulposus: Feasibility, Safety, and Preliminary Clinical Results. AJNR Am J Neuroradiol, NovDec 2006; 27(10): 2104-11. PMCID: PMC7977204. PMID: 17110676 https://pubmed.ncbi.nlm.nih.gov/17110676/

Kumar NS, Shah SM, Tan BWL, Juned S, Yao K. Discogenic axial back pain: is there a role for nucleoplasty? Asian Spine J, 2013 Dec; 7(4): 314-21. Epub 2013 Nov 28. DOI:10.4184/asj.2013.7.4.314. PMCID: PMC3863658. PMID: 24353849 https://pubmed.ncbi.nlm.nih.gov/24353849/

Yan D, Li J, Zhu H, Zhang Z, Duan L. Percutaneous cervical nucleoplasty and percutaneous cervical discectomy treatments of the contained cervical disc herniation. Arch Orthop Trauma Surg, 2010 Nov; 130(11): 1371-6. Epub 2010 Jan 8. DOI: 10.1007/s00402-009-1041-3. PMID: 20058017 https://pubmed.ncbi.nlm.nih.gov/20058017/

Ren D‑J, Liu X-M, Du S-Y, Sun T-S, Zhang Z-C, Li F. Percutaneous Nucleoplasty Using Coblation Technique for the Treatment of Chronic Nonspecific Low Back Pain: 5-year Follow-up Results. Chin Med J (Engl), 2015 Jul 20; 128(14): 1893-7. DOI: 10.4103/0366-6999.160518. PMCID: PMC4717925. PMID: 26168829 https://pubmed.ncbi.nlm.nih.gov/26168829/

Pandolfi M, Galli F, Borelli A, Gurgitano M, Liguori A, Carrafello G. Percutaneous cervical coblation as therapeutic technique in the treatment of algo-dysfunctional pain of discal herniation. Radiol Med, 2021 Jun; 126(6): 860-868. Epub 2021 Feb 23. DOI: 10.1007/s11547-021-01336-w. PMCID: PMC8154794. PMID: 33620665 https://pubmed.ncbi.nlm.nih.gov/33620665/

Ebrahim KS, Shehaby A Al, Wardany M Al, Darwish A, Awad M. Percutaneous image guided lumbar disc nucleoplasty: a minimal invasive technique for lumbar disc decompression. Pan Arab J Neurosurgery, 2010; 14(2): 51-55. P-ISSN: 1319-6995 https://vlibrary.emro.who.int/imemr/percutaneous-image-guided-lumbar-disc-nucleoplasty-a-minimalinvasive-technique-for-lumbar-disc-decompression-2/

Reddy A S, Loh S, Cutts J, Rachlin J, Hirsch J A. New approach to the management of acute disc herniation. Pain Physician, 2005 Oct; 8(4): 385-90. PMID: 16850062 https://pubmed.ncbi.nlm.nih.gov/16850062/

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 Jan; 85(1): 6-13. DOI: 10.1097/01.phm.0000184153.98344.a4. PMID: 16357543 https://pubmed.ncbi.nlm.nih.gov/16357543/

Zhu H, Zhou X-Z, Cheng M-H, Shen Y-X, Dong QR. The efficacy of coblation nucleoplasty for protrusion of lumbar intervertebral disc at a two-year follow-up. Int Orthop, 2011 Nov; 35(11): 1677-82. Epub 2011 Jan 15. DOI: 10.1007/ s00264-010-1196-0. PMCID: PMC3193964. PMID: 21240606 https://pubmed.ncbi.nlm.nih.gov/21240606/

Adakli B, Turhan KSC, Asik I. The comparison of the efficacy of radiofrequency nucleoplasty and targeted disc decompression in lumbar radiculopathy. Bosn J Basic Med Sci, 2015 Apr 25; 15(2): 57-61. DOI: 10.17305/ bjbms.2015.427. PMCID: PMC4469937. PMID: 26042514 https://pubmed.ncbi.nlm.nih.gov/26042514/

Nikolopoulos P, Maniatis P, Giannila AP, Kelekis AD, Papailiou J, Triantopoulou C. Percutaneous disc decompression using nucleoplasty in patients with discogenic low back pain. ECR 2012 / C-2358. DOI: 10.1594/ecr2012/C-2358. DOILink: https://dx.doi.org/10.1594/ecr2012/C-2358 https://epos.myesr.org/poster/esr/ecr2012/C-2358

Cincu R, Lorente FdA, Gomez J, Eiras J, Agrawal A. One decade follow up after nucleoplasty in the management of degenerative disc disease causing low back pain and radiculopathy. Asian J Neurosurg, Jan-Mar 2015; 10(1): 21-5. DOI: 10.4103/1793-5482.151504. PMCID: PMC4352623. PMID: 25767571 https://pubmed.ncbi.nlm.nih.gov/25767571/

Li C, Qi Y, Liu G, Yin X, Jin Y, Jiang Z, Li P, Kang X, Ye C. Long-Term Clinical Outcomes of Percutaneous Cervical Nucleoplasty for Cervical Degenerative Diseases with Neck Pain and Cervical Vertigo. World Neurosurg, 2020 Jan; 133: e205-e210. Epub 2019 Sep 5. DOI:10.1016/j.wneu.2019.08.210. PMID: 31493606. https://pubmed.ncbi.nlm.nih.gov/31493606/

Karabekir HS, Atar E, Yildizhan A, Yazici AC, Yonguc ND, Mas NG. Morphometrical and Clinical Analysis of Cervical Nucleoplasty Cases Using Coblation Technique. Spine Research, ISSN 2471-8173, 2017, Vol. 3 No. 1:7. DOI: 10.21767/2471-8173.100021 https://spine.imedpub.com/morphometrical-and-clinical-analysis-of-cervicalnucleoplasty-cases-using-coblation-technique.pdf

Halim W, Wullems JA, Lim T, Aukes HA, van der Weegen A, Vissers KC, Gültuna I, Chua NHL. The long-term efficacy and safety of percutaneous cervical nucleoplasty in patients with a contained herniated disk. Pain Pract, 2013 Jun; 13(5): 364-71. Epub 2012 Oct 31. DOI:10.1111/papr.12003. PMID: 23113964 https://pubmed.ncbi.nlm.nih.gov/23113964/

Azzazi A, AlMekawi S, Zein M. Lumbar disc nucleoplasty using coblation technology: clinical outcome. J Neurointerv Surg, 2011 Sep; 3(3): 288-92. Epub 2010 Dec 8. DOI: 10.1136/jnis.2010.002402. PMID: 21990844 https://pubmed.ncbi.nlm.nih.gov/21990844/

Yakovlev A, Tamimi MA, Liang H, Eristavi M. Outcomes of percutaneous disc decompression utilizing nucleoplasty for the treatment of chronic discogenic pain. Pain Physician, 2007 Mar; 10(2): 319-28. PMID: 17387355 https://pubmed.ncbi.nlm.nih.gov/17387355/

Sim S E, Ko E S, Kim D K, Kim H K, Kim Y C, Shin H Y. The results of cervical nucleoplasty in patients with cervical disc disorder: a retrospective clinical study of 22 patients. Korean J Pain, 2011 Mar; 24(1): 36-43. DOI: 10.3344/ kjp.2011.24.1.36. Epub 2011 Feb 25. PMCID: PMC3049975. PMID: 21390177 https://pubmed.ncbi.nlm.nih.gov/21390177/

Liliang P-C, Lu K, Liang C-L, Chen Y-W, Tsai Y-D, Tu Y-K. Nucleoplasty for treating lumbar disk degenerative low back pain: an outcome prediction analysis. J Pain Res, 2016 Oct 31; 9: 893-898. eCollection 2016. DOI: 10.2147/JPR. S116533. PMCID: PMC5096781. PMID: 27826211 https://pubmed.ncbi.nlm.nih.gov/27826211/

Marín FZ. CAM versus nucleoplasty. Acta Neurochir Suppl, 2005; 92: 111-4. DOI: 10.1007/3-211-27458-8_24. PMID: 15830980 https://pubmed.ncbi.nlm.nih.gov/15830980/

Lerardi A M, Carnevale A, Cossu A, Coppola A, Fumarola E M, Garanzini E, Silipigni S, Biasina A M, Paolucci A, Giganti M, Carrafello G. Percutaneous cervical discectomy: retrospective comparison of two different techniques. Radiol Med, 2020 Jun; 125(6): 569-577. DOI: 10.1007/s11547-020-01133-x. Epub 2020 Feb 10. PMID: 32040719 https://pubmed.ncbi.nlm.nih.gov/32040719/

Lee DW, Loh ESY, Kueh CC, Poi JH, Francis T, Koh KC, Wazir NN, Singh H. Radiofrequency-induced intradiscal nucleoplasty chronic low back pain secondary to lumbar disc herniation. Malays Orthop J, 2013 Jul; 7(2): 18-20. DOI: 10.5704/MOJ.1307.009. PMCID: PMC4341032. PMID: 25722820 https://pubmed.ncbi.nlm.nih.gov/25722820/

Agarwal A, Shamshery C, Ambesh SP, Jain A. Evaluation of nucleoplasty in patients of low back pain with radiculopathy: A preliminary report. Anaesth, Pain & Intensive Care, Vol 19(3), Jul-Sep 2015. https://www.apicareonline.com/index.php/APIC/article/view/817/1165

Curtis W Slipman CW, Bhat AL, Gilchrist RV. Preliminary results for axial low back pain treated with Coblation: A comparison of patients with and without central focal protrusion. European Spine Journal, January 2002, 11: 416-417 https://www.researchgate.net/publication/312980459_Preliminary_results_for_axial_low_back_pain_treated_with_Coblation_A_comparison_of_patients_with_and_without_central_focal_protrusion

Liguori A, Galli F, Gurgitano M, Borelli A, Pandolfi M, Caranci F, Biasina AMM, Pompili GGM, Piccolo CL, Miele V, Masciocchi C, Carrafiello G. Clinical and instrumental assessment of herniated discs after nucleoplasty: a preliminary study. Acta Biomed, 2018 Jan 19; 89(1-S): 220-229. DOI: 10.23750/abm.v89i1-S.7025. PMCID: PMC6179072. PMID: 29350650 https://pubmed.ncbi.nlm.nih.gov/29350650/

Zhu H, Zhou XZ, Cheng MH, Luo ZP, Ai HZ. Coblation nucleoplasty for adjacent segment degeneration after posterolateral fusion surgery: a case report. Back Musculoskelet Rehabil, 2012; 25(4): 235-8.DOI: 10.3233/BMR-2012- 0341. PMID: 23220805. https://pubmed.ncbi.nlm.nih.gov/23220805/

Smuck M, Benny B, Han A, Levin J. Epidural fibrosis following percutaneous disc decompression with coblation technology. Pain Physician, 2007 Sep; 10(5): 691-6. PMID: 17876367 https://pubmed.ncbi.nlm.nih.gov/17876367/

Buy X, Gangi A. Percutaneous treatment of intervertebral disc herniation. Semin Intervent Radiol, 2010 Jun; 27(2): 148-59. DOI: 10.1055/s-0030-1253513. PMCID: PMC3036519. PMID: 21629404. https://pubmed.ncbi.nlm.nih.gov/21629404/

Jung YS, Choi SP, Sim S-E. Cervical nucleoplasty as an effective treatment method of cervical degenerative disc disease. Korean J Anesthesiol, 2013 Dec; 65 (6 Suppl): S53-5. DOI: 10.4097/kjae.2013.65.6S.S53. PMCID: PMC3903860. PMID: 24478872 https://pubmed.ncbi.nlm.nih.gov/24478872/

Preclinical Evidence

Chen YC, Lee SH, Chen D. Intradiscal pressure study of percutaneous disc decompression with nucleoplasty in human cadavers. Spine (Phila Pa 1976), 2003 Apr 1; DOI: 10.1097/01.BRS.0000051920.45671.88. PMID: 12671352. https://pubmed.ncbi.nlm.nih.gov/12671352/

Kasch R, Mensel B, Schmidt F, Ruetten S, Barz T, Froehlich S, Seipel R, Merk HR, Kayser R. Disc volume reduction with percutaneous nucleoplasty in an animal model. PLoS One, 2012; 7(11): e50211. DOI: 10.1371/journal.pone.0050211. Epub 2012 Nov 27. PMCID: PMC3507698. PMID: 23209677 https://pubmed.ncbi.nlm.nih.gov/23209677/

Ren D, Zhang Z, Sun T, Li F. Effect of percutaneous nucleoplasty with coblation on phospholipase A2 activity in the intervertebral disks of an animal model of intervertebral disk degeneration: a randomized controlled trial. J Orthop Surg Res, 2015 Mar 25; 10: 38. DOI: 10.1186/s13018-015-0175-y. PMCID: PMC4384310. PMID: 25879590 https://pubmed.ncbi.nlm.nih.gov/25879590/

Kuelling FA, Foley KT, Liu JJ, Liebenberg E, Sin AH, Matsukawa A, Lotz JC. The anabolic effect of plasma-mediated ablation on the intervertebral disc: stimulation of proteoglycan and interleukin-8 production. Spine J, 2014 Oct 1; 14(10): 2479-87. Epub 2014 Apr 18. PMID: 24747799. DOI: 10.1016/j.spinee.2014.04.010. https://pubmed.ncbi.nlm.nih.gov/24747799/

Chen YC, Lee S-H, Saenz Y, Lehman NL. Histologic findings of disc, end plate and neural elements after coblation of nucleus pulposus: an experimental nucleoplasty study. Spine J, Nov-Dec 2003; 3(6): 466-70. DOI: 10.1016/s1529- 9430(03)00143-8. PMID: 14609691 https://pubmed.ncbi.nlm.nih.gov/14609691/

Lee MS, Cooper G, Lutz GE, Doty SB. Histologic characterization of coblation nucleoplasty performed on sheep intervertebral discs. Pain Physician, 2003 Oct; 6(4): 439-42. PMID: 16871295 https://pubmed.ncbi.nlm.nih.gov/16871295/

O’Neill C, Liu J, Leibenberg E, Hu S, Deviren V, Tay B, Chin C, Lotz J. Percutaneous plasma decompression alters cytokine expression in injured porcine intervertebral discs. Spine J, Jan-Feb 2004; 4(1): 88-98. DOI: 10.1016/s1529- 9430(03)00423-6. PMID: 14749197 https://pubmed.ncbi.nlm.nih.gov/14749197/

Scientific Evidence

Stalder KR, Woloszko J, Brown IG. Plasma characteristics of repetitively-pulsed electrical discharges in saline solutions used for surgical procedures, IEEE Transactions on Plasma Science, July 2002 30(3): 1376-1383. DOI: 10.1109/
TPS.2002.801612 https://www.researchgate.net/publication/3165337_Plasma_characteristics_of_repetitively-puIsed_electrical_discharges_in_saline_solutions_used_for_surgical_procedures

Stalder KR, McMillen DF and Woloszko J. Electrosurgical plasmas. J Phys D: Appl Phys, 38 (2005) 1728–1738. https://iopscience.iop.org/article/10.1088/0022-3727/38/11/014