Percutaneous Discectomy

Percutaneous discectomy is a minimally invasive technique in which the herniated disc material is removed through a very small cut made in the skin. Herniated disc is a condition in which the outer fibers (annulus) of the intervertebral disc are damaged causing the soft inner material of the nucleus pulposus to rupture out of its space. If the herniated disc presses on a spinal nerve, it can cause pain.

Preparation

All patients will be evaluated before the procedure. The evaluation includes your medical history, physical exam, and diagnostic tests. Diagnostic tests such as MRI, CT scan, or myelogram may be done to see a non-ruptured bulging disc.

There is very little preparation for this procedure. You will need to bring someone with you to take you home as you should not drive for at least 24 hours after the procedure. Inform your doctor about any medications you are currently taking.

Procedure

There are several ways in which a percutaneous discectomy procedure may be performed. Almost all the methods require insertion of small instruments in between the vertebrae and into the middle part of the disc. You will be given a local anesthetic and mild sedative to relax you during the procedure. During the procedure, an instrument is inserted through a needle and placed in the middle part of the disc. The position of the small instruments is monitored with the help of X-rays. Your surgeon may remove the disc tissue by one of the three methods: cutting the disc out, suctioning out the central portion of the disc, and burning down the disc with a laser. This relieves the pressure on the surrounding nerves and eliminates the pain from the herniated disc. The injection site is covered with a dry, sterile bandage.

A percutaneous discectomy procedure takes about 30 minutes to perform.

Post Procedure protocol

You may return back home the same day after percutaneous discectomy. During the recovery period, you may feel slight pain which can be taken care of with pain medications. You will be advised to avoid lifting heavy weights or strenuous exercises until several weeks. Physical therapy exercises may be prescribed for faster rehabilitation.

Indications

Percutaneous discectomy is used to treat non-ruptured herniated disc or a bulging disc which can cause symptoms such as low back pain and leg pain. Percutanoeus discectomy may be considered as a treatment option if diagnostic tests performed have confirmed the presence of a bulging disc that has not separated into the spinal canal. Your doctor may also recommend this treatment if your symptoms get worse and interfere with normal activities without improvements even after four weeks of conservative treatment. Signs of nerve damage becoming worse may also necessitate percutaneous discectomy procedure.

Benefits

Benefits of radiofrequency ablation include:

  • Little tissue trauma
  • Relieve your symptoms of leg pain and back pain
  • Pain relief is sustained through one year post-procedure
  • Fewer risks of complication
  • Less recovery time

Risks/Side effects

With lower risks of complications, percutaneous discectomy is considered an appropriate treatment for many patients who suffer from back and leg pain symptoms. You may feel slight pain after the procedure which can be taken care of with pain medications.



HARVARD MEDICAL SCHOOL ASHPP PENN SIS AMA NASS aaPM&R ISASS - The International Society for the Advancement of Spine Surgery