A foraminotomy is an operation that "cleans out" or enlarges the bony hole (foramen) where a nerve root exits the spinal canal. Bulging discs or joints thickened with age can cause narrowing of the space through which the spinal nerve exits. This can press on the nerve, resulting in pain, numbness, and weakness in an arm or leg. Small pieces of bone over the nerve are removed through a small slit, allowing the surgeon to cut away the blockage and relieve the pressure on the nerve.

 

Intradiscal electrothermal therapy (IDET) uses thermal energy to treat pain resulting from a cracked or bulging spinal disc. A special needle is inserted through a catheter into the disc and heated to a high temperature for up to 20 minutes. The heat thickens, seals the disc wall, and reduces inner disc bulge and irritation of the spinal nerve.

 

Nucleoplasty uses radiofrequency energy to treat patients with lower back pain from contained, or mildly herniated, discs. Guided by x-ray imaging, a wand-like instrument is inserted through a needle into the disc to create a channel that allows inner disc material to be removed. The wand will then heat and shrink the tissue, sealing the disc wall. Several channels are made, depending on how much disc material needs to be removed.

 

Radiofrequency lesioning is a procedure that uses electrical impulses to interrupt nerve conduction (including the conduction of pain signals) for up to 6 to 12 months. Using x-ray guidance, a special needle is inserted into nerve tissue in the affected area. Tissue surrounding the needle tip is heated for 90 to 120 seconds, resulting in localized destruction of the nerves.