Laser Treatment (Nucleoplasty) is the procedure of reaching the inside of the disc with a special electrode under imaging guidance and then delivering a laser or radiofrequency current. The aim of the procedure is to lower the pressure inside the disc, thereby drawing the herniated portion of the disc back toward the disc space (regression), and in this way to eliminate the nerve compression causing the pain.
No extensive preparation is required. The procedure is performed under local anaesthesia and takes about 30 minutes. Patients are usually able to go home after approximately two hours of observation and are advised to rest for two days. Side effects are very rare; serious complications such as bleeding or nerve damage are almost never seen, and infection is extremely uncommon.
Appointments & practical information
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You can send your appointment request via WhatsApp, by phone or through the contact form. Briefly describing your complaint and the times that suit you speeds things up; we respond as quickly as possible.
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If available, bring your recent MRI and CT images, previous test and surgery reports, and a list of the medication you take regularly. This makes the assessment considerably easier.
What happens at the first consultation?
We listen to your complaints and history, perform a neurological examination and review your existing images together. Treatment options are then planned with you, taking your expectations and lifestyle into account.
Second opinion
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Nucleoplasty is a minimally invasive (non-surgical) method that aims to treat the herniation by lowering the pressure inside the disc. It is a procedure in which part of the "nucleus pulposus" layer at the center of the disc is vaporized with radiofrequency energy. This procedure causes the herniated tissue to retract from the nerve, resolving the pain at its source.
How Is Nucleoplasty Performed?
The procedure is performed under operating-room conditions, in full compliance with sterilization rules. Guided by fluoroscopy (live X-ray), a millimetric cannula is placed into the herniated area. A special electrode passed through the cannula emits controlled energy, creating small channels inside the disc and reducing the tissue volume. The patient can follow the entire process while awake.
What Are the Side Effects and Risks of Nucleoplasty?
Nucleoplasty is one of the interventions with the lowest risk profile in the literature. The risk of bleeding, infection or tissue adhesion — as seen in open surgery — is below 1%. Thanks to fluoroscopic control, the possibility of damaging surrounding tissues or nerves remains under the surgeon's direct control.
How Many Days Does It Take for Nucleoplasty to Take Effect?
Mechanical relief begins at the moment of the procedure; however, the dispersal of the edema around the nerve and the disc's adaptation to its new form usually become noticeable within the first week. Our patients feel a dramatic reduction in their leg pain from day 3-4 onward.
Does Nucleoplasty Eliminate the Herniation?
Nucleoplasty does not physically cut out the herniation; it changes the herniation's biomechanics. By reducing the pressure inside the disc by about 10-20%, it pulls the protruding herniation's pressure off the nerve root through a "vacuum effect". As the nerve is relieved, the pain disappears.
What Does Nucleoplasty Consist Of?
This is not a drug injection. The essence of the procedure is "Coblation" (cold plasma) technology. It breaks down the protein bonds inside the disc at the molecular level, at low temperatures (40-70 degrees). This achieves volume reduction without causing heat damage to the surrounding tissues.
What Should Be Considered After Nucleoplasty?
Bed rest during the first 24 hours after the procedure is important. For the following 10 days, heavy lifting, sitting in the same position for long periods and sudden lower-back movements should be avoided. We provide our patients with the principles of protecting the lower back as a detailed guide after the procedure.
Which Department Performs Nucleoplasty?
It should be performed in Brain and Nerve Surgery (Neurosurgery) clinics specialized in spine surgery and micro-anatomy, in a fully equipped operating-room environment.
What Type of Anesthesia Is Used for the Nucleoplasty Procedure?
Local numbing (local anesthesia) alone is sufficient. In some cases, light sedation (a relaxing sleep-like state) is added for the patient's comfort. It is a safe alternative for people for whom general anesthesia is risky (such as heart or lung patients).
Are Stitches Needed After the Nucleoplasty Procedure?
No. The procedure is performed through a single needle entry hole. Since no surgical blade is used, no stitches are needed; the entry site is covered with a small adhesive bandage and heals without leaving a scar.
How Long Does the Nucleoplasty Treatment Procedure Take?
The application time for a single level (disc) is about 15-20 minutes. Including the patient's preparation and post-procedure observation, the entire process is completed within 1-2 hours.
Is There an Age Limit for Nucleoplasty Treatment?
There is no specific age limit. However, the success rate is higher in patients aged 18-65, in whom the disc's "water content" is biologically preserved (discs that have not dried out much). At advanced ages, it can be applied safely as long as it is not accompanied by canal narrowing.
For Which Stages of Herniation Is Nucleoplasty Treatment Suitable?
The most successful results are obtained in stages where the disc's outer layer (annulus) is not torn and the herniation only bulges outward (bulging or protrusion). For moderate herniations, it is the strongest step before surgery.
Does Nucleoplasty Work If the Herniation Has Ruptured?
In the case of a "ruptured herniation" (sequestered herniation), if the fragment has completely separated from the disc and dropped into the canal, nucleoplasty is not effective. In that case, microsurgery is recommended. However, if the fragment has not broken off, it can be applied following the specialist surgeon's assessment.
How Long Is the Recovery Time With Nucleoplasty Treatment?
Recovery begins within 48-72 hours. The final result becomes apparent within 10 days.
Can I Be Discharged the Same Day After Nucleoplasty Treatment?
Yes, nucleoplasty is an "outpatient" (day-case) procedure. After a 2-hour rest following the procedure and a first walk, we send our patients home the same day.
When Can I Shower After Nucleoplasty Treatment?
Since there is no incision or dressing, you can shower from day 1 onward.
When Can I Return to Work After Nucleoplasty Treatment?
Those with desk jobs can return to work on day 3. For those working in active jobs requiring heavy physical strength, resting for 1-2 weeks is the healthier option.
Is Physical Therapy Needed After Nucleoplasty Treatment?
Nucleoplasty resolves the mechanical pressure; however, a physical therapy program started 2-3 weeks after the procedure — to strengthen the back muscles and prevent the herniation from recurring — makes the success lasting.
Can I Travel by Plane or Bus After Nucleoplasty Treatment?
Short-distance flights are possible 48 hours after the procedure. For long bus journeys, waiting 1 week — provided the spine is supported — is more comfortable in terms of letting the nerve edema settle.
When Will My Pain Completely Disappear After Nucleoplasty Treatment?
The vast majority of patients experience 80% relief by the end of the first week. The remaining mild aches disappear completely within 1 month, as the internal pressure of the disc settles into balance.
What Is the Risk of the Herniation Recurring After Nucleoplasty Treatment?
The risk rate is similar to that of surgical methods (5-8%). However, in patients who protect their back muscles and maintain weight control after nucleoplasty, this risk is minimized.
What Is the Success Rate of Nucleoplasty Treatment?
With the right patient selection (if the stage of the herniation and the structure of the disc are suitable), the success rate is between 80-85%. Medically, this is a very high level for a non-surgical method.
Can I Have Surgery If I Don't Benefit From Nucleoplasty Treatment?
Yes. Nucleoplasty does not disturb the anatomical integrity of the spine and does not damage bone tissue. Therefore, it poses no obstacle whatsoever to a microsurgical intervention that may be needed in the future.
What Is the Difference Between Laser Herniation Treatment and Nucleoplasty?
Laser burns the disc using high heat (thermal energy), which can create a risk of heat damage in the surrounding nerve tissue. Nucleoplasty, on the other hand, uses plasma energy (cold vaporization). Because it works at much lower temperatures, the risk of nerve damage is negligible.
What Are the Advantages of Nucleoplasty Treatment Over Surgery?
Its greatest advantages are that it requires no general anesthesia, involves no hospital stay, needs no stitches, and does not create the scar tissue (adhesions) that causes "failed back surgery" syndrome.
Does Nucleoplasty Treatment Require Any Incision or Stitches?
No, no surgical scalpel is used. The procedure is completed through just a one-millimeter needle entry.
How Long Does the Nucleoplasty Procedure Take?
The pure procedure time averages 20 minutes. As an interventional pain treatment, it is an extremely fast and effective method.
Can I Be Discharged the Same Day After the Nucleoplasty Procedure?
Yes, after a short clinical follow-up following the procedure, the patient can walk out and return home on their own.
Is Nucleoplasty a Safe Method?
It is an FDA-approved technology with proven reliability, applied thousands of times worldwide. Being performed under imaging guidance gives the surgeon full control at every step.
Is There a Possibility of Nerve Damage With Nucleoplasty?
With the help of fluoroscopy, the tip of the needle is advanced within a safe "tunnel", away from the nerve. Moreover, thanks to the low-heat (cold plasma) technology there is no heat spread, which brings the possibility of nerve damage theoretically close to zero.
