This is a newer intervention where radiofrequency energy is used with two major aims, viz. sealing of the ruptured annulus and desensitizing the pain generators in the posterior part of the annulus. Biacuplasty is a mild modification of IDET which is much more costly and involves a certain amount of risk of cannula breakage and damage to surrounding structures. Advantages of biacuplasty are its simplicity, relatively cost effectiveness and use of bipolar radiofrequency energy at 42 degrees centigrade only thereby preventing any damage to surrounding nervous structures. Bipolar mode also covers a bigger and broader area of radiofrequency application with least trauma. Like ozone nucleolysis biacuplasty is performed in a fully equiped operating room under fluoroscopy.
Local anesthesia is used to introduce two cannulae in the affected disc one from each side. After testing for sensory and motor stimulation to avoid any inadvertant damage to the surrounding nervous system bipolar pulsed radiofrequency is applied for 20-30 minutes. Patient can go back home the same day after a monitoring of 1-2 hours. Like ozone nucleolysis bed rest for 2-3 days is desirable for healing. No cutting of tissues or bone is undertaken and hence is extremly safe.