What Is Percutaneous Discectomy?Back pain is a very common condition that affects millions of adults in the United States. It is estimated that approximately 2% of the workforce in the U.S. files for workers’ compensation because of back pain. Oftentimes, back pain can be relieved with conservative treatment options including ice, heat, physical therapy, analgesic medication and non-steroidal anti-inflammatory drugs (NSAIDs). However, patients who experience more severe and chronic back pain are often treated with narcotics and invasive surgery.
Disc herniation is one of the most common causes of back pain, which results in chronic and sometimes debilitating pain. An intervertebral disc is comprised of an inner layer (nucleus pulposus) and an outer layer (annular fibrosis). If the outer layer of the disc begins to deteriorate, it can weaken, allowing the inner layer to push outward. The protruding inner layer may irritate or impinge on spinal nerves in the area, resulting in chronic back, and even extremity pain.
Patients who report back pain that is caused by a herniated disc rarely have pain relief with conservative treatment. Many different types of treatment have been developed over the last decade to offer non-invasive treatment options to these patients instead of invasive surgery. Percutaneous discectomy has been one of the developments.
Percutaneous discectomy is a minimally invasive procedure that is offered to patients who have a contained disc herniation that has not responded to conservative treatment options. This procedure was developed to shrink or remove the material surrounding the herniated disc that is thought to be causing the inflammation and back pain. After the material is removed, patients usually experience pain relief as well as less pressure on the surrounding spinal nerves. Studies have found that the success rate of percutaneous discectomy is over 80%.
How Is Percutaneous Discectomy Performed?Prior to the percutaneous discectomy procedure, the patient is given a sedative to help them remain calm during the procedure. The patient is placed in a prone position on the treatment table. The physician then injects a local anesthetic using a small needle to numb the area. Once the tissue is numb, a larger needle or probe is inserted through the skin into the affected intervertebral disc using fluoroscopic guidance.
Once the needle or probe is positioned properly, heat or radio waves are used to decrease the disc size and remove any disruptive disc material. Removing the disc material from the herniated discs helps to reduce pressure in the disc and provides pain relief. Following the percutaneous procedure, the patient is moved to a recovery area to be monitored.
Percutaneous discectomy generally takes approximately 30 minutes to perform and is completed in an outpatient setting. Typically patients can return home within one to three hours after the procedure. The injection site may be tender for 24 to 48 hours after the procedure. Heat or cold packs are recommended to ease any discomfort. Additionally, some physicians may prescribe pain medication for patients to take following the procedure. Patients are advised to rest and limit activity for about 24 hours after the procedure. While recovery times vary for each patient, most patients are able to resume normal work and leisure activities in one week.