Percutaneous Nucleolysis for Lumbar Disc Herniation: Historical Development, Pathophysiological Basis, Indications, and Clinical Outcomes
DOI:
https://doi.org/10.70577/c6tkwj11Keywords:
Nucleólisis Percutánea, Hernia Discal Lumbar, Nucleoplastia, Quimionucleólisis, Descompresión Discal.Abstract
Lumbar disc herniation is one of the leading causes of low back pain and radiculopathy in adults, resulting in substantial functional impairment and socioeconomic burden. In this context, percutaneous nucleolysis has emerged as a minimally invasive therapeutic alternative aimed at reducing intradiscal pressure and relieving nerve root compression through different physical and chemical mechanisms. The objective of this literature review was to analyze the historical evolution of percutaneous nucleolysis, its pathophysiological basis, clinical indications, therapeutic outcomes, and current role in the management of lumbar disc herniation. A narrative review was conducted using international scientific databases, including PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar. Studies addressing chemonucleolysis, radiofrequency nucleoplasty, mechanical percutaneous disc decompression, laser disc decompression, and modern gelified ethanol techniques were included. The findings indicate that these minimally invasive procedures provide significant improvements in pain relief and functional recovery when applied to appropriately selected patients, particularly those with contained lumbar disc herniations refractory to conservative treatment. In addition, they are associated with low complication rates and shorter recovery times compared with conventional surgical procedures. It is concluded that percutaneous nucleolysis represents a safe and effective therapeutic option within the minimally invasive management of lumbar disc herniation; however, further prospective studies are required to optimize patient selection criteria and strengthen the available scientific evidence.
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