What is an annuloplasty?

An annuloplasty is a minimally invasive spine procedure that alleviates chronic back pain caused by issues within the intervertebral discs, such as disc herniation or degeneration. Over time or due to injury, the discs in our spine can become damaged. They may herniate (bulge out), degenerate (wear down), or tear, leading to chronic pain and mobility issues. These problems often arise in the lumbar spine (lower back), causing significant discomfort and limiting daily activities.

An annuloplasty targets the annulus fibrosus, the outer layer of the disc, without the need for open back surgery. It helps to repair or strengthen the affected disc and surrounding area to relieve pain and restore function.

annulus fibrosus
An annuloplasty targets the annulus fibrosus of the intervertebral disc.

How does an annuloplasty work?

A disc annuloplasty involves the insertion of a catheter into the affected disc under the guidance of imaging technology. Through this catheter, a heating element is introduced to the disc’s inner structures. Once correctly positioned, the heating element is activated to a controlled temperature. 

The heat applied has multiple purposes: it can seal tears in the disc wall, deactivate nerve fibres that are transmitting pain signals, and encourage the tightening or thickening of the disc material, potentially leading to pain relief and increased disc stability.

Annuloplasty represents a modern approach to tackling chronic back pain associated with disc problems, offering a less invasive alternative to traditional surgery with a relatively quick recovery period and promising results for many patients.

Benefits of an annuloplasty

  • Minimally invasive nature: an annuloplasty does not require open surgery. This means less tissue damage, a lower risk of complications, and no need for an extended hospital stay.
  • Quick recovery time: an annuloplasty is typically conducted on an outpatient basis, allowing patients to return home the same day. The recovery process is much quicker than traditional surgery, with patients often resuming daily activities sooner.
  • Effective pain relief: patients experience a significant reduction in chronic back pain and an improvement in back functionality. The treatment can also reduce the need for long-term pain medication.
  • High success rate: studies and patient reports have highlighted a high success rate in pain reduction and overall satisfaction with minimal complications. Some studies report up to a 90% success rate in pain reduction for patients treated with this method. 

What conditions can an annuloplasty treat? 

Annuloplasty is effective for a wide range of disc-related conditions, including but not limited to:

  • Herniated discs: herniated or slipped discs occur when the soft inner material of the disc bulges out through a tear in the annulus fibrosus. Annuloplasty aims to repair the damaged annulus fibrosus, reducing pressure on the nerves and alleviating symptoms associated with disc herniation.
  • Degenerative disc disease: degenerative disc disease occurs when the discs between the vertebrae lose cushioning and fragment, causing pain. Annuloplasty can help stabilise the affected discs by reinforcing the annulus fibrosus, restoring spinal alignment, and reducing symptoms associated with disc degeneration.
  • Discogenic back pain: discongenic back pain originates from the intervertebral discs rather than surrounding structures such as muscles or nerves. Annuloplasty can address these tears and promote healing of the annulus fibrosus, thereby reducing discogenic back pain and improving overall spinal function.

Other disc-related concerns: annuloplasty may also be indicated for other disc-related disorders, such as annular tears, disc protrusion, or disc bulge, which can contribute to spinal instability, nerve compression, and associated symptoms. By addressing the underlying pathology within the intervertebral discs, annuloplasty helps restore spinal health and function, allowing individuals to experience relief from pain and regain their quality of life.

annuloplasty treatment singapore
An annuloplasty can treat disc protrusion, disc bulge, and herniated discs.

What results can I expect after an annuloplasty?

After undergoing an annuloplasty procedure, patients can anticipate various outcomes, primarily centred around pain relief and improved quality of life. Here’s what you can generally expect after an annuloplasty:

  • Pain relief: the primary goal of annuloplasty is to alleviate chronic back pain caused by disc-related issues. Many patients report a significant reduction in pain following the procedure. The relief comes from the thermal heat applied during the process, which helps to seal tears in the disc wall and may deactivate nerve fibres that send pain signals.
  • Quicker recovery: the minimally invasive nature of the procedure means patients can often return home the same day of their treatment and may resume normal activities much quicker. While the exact recovery time can vary from person to person, it is typically faster than recovery from traditional spine surgeries.
  • Improved mobility: with the reduction or elimination of pain, many patients experience improved mobility. This improvement can make daily activities easier and allow for a return to hobbies or exercises that were too painful to perform before the procedure.
  • Decreased medication dependence: as pain diminishes post-procedure, there may be a reduced need for pain medication. This aspect is particularly beneficial for those who have relied on pain relievers for an extended period and are concerned about the potential side effects of long-term medication use.

The results also depend on the specific conditions being treated. For example, patients with herniated discs or degenerative disc disease might notice different levels of improvement based on the severity of their condition before the procedure.

In some cases, additional treatments may be necessary to fully address the underlying issues causing pain. Annuloplasty can be a significant step toward relieving pain. Still, it may need to be part of a broader treatment plan, including physical therapy or lifestyle modifications, to ensure the best possible long-term outcome.

How many sessions of an annuloplasty are needed?

The number of annuloplasty sessions required can vary based on the individual’s condition and response to the initial treatment. However, many patients experience significant relief after just a single session.

Frequently Asked Questions

While both aim to alleviate pain by addressing disc issues, annuloplasty focuses on repairing the disc’s annulus, and nucleoplasty involves removing part of the nucleus to relieve pressure.

The effects can be long-lasting, with many patients reporting sustained pain relief and improved functionality for months to years after the procedure​.

While generally safe, all medical procedures carry some risk. For annuloplasty, these include infection, bleeding, and nerve irritation, though such complications are rare.