Project Description

Dr. Tory McJunkin gives a detailed explanation and demonstration of a percutaneous discectomy procedure. He also explains how someone suffering from chronic pain can benefit from such a procedure.

Watch Pain Doctor Tory McJunkin Perform Percutaneous Discectomy.

According to the Global Burden of Disease 2010, low back pain is the single leading cause of disability worldwide. It has been estimated that over 31 million adults in the United States experience low back pain at any given point in time. The burden that spinal pain places on the workforce is undeniable, as it has been estimated that about 2% of the U.S. workforce files a workers’ compensation claim each year due to spinal pain.

In many cases, spinal pain can be reduced by utilizing conservative treatment methods, including heat, ice, physical therapy exercises, and pain and anti-inflammatory medications. However, some patients may continue to experience chronic and severe spinal pain despite trying these interventions. These patients are often prescribed narcotic medications or are advised to undergo invasive spinal surgery.

One of the most common causes of chronic spinal pain is disc herniation. Intervertebral discs are found between the vertebrae of the spine and consist of an inner, spongy layer and an outer, fibrous layer. When the outer layer of the intervertebral disc weakens, the inner layer may protrude outward. This can result in irritation or impingement of the surrounding spinal nerves.

Irritation and impingement of spinal nerves can lead to chronic spinal and possibly extremity pain. When a disc herniation is responsible for chronic pain, conservative treatment measures usually fail. Over the past ten years, various different treatments have been developed to offer to patients as an alternative to surgery. Percutaneous discectomy was one of these developments.

Percutaneous discectomy is a safe and relatively minimally invasive option that can be offered to patients who have contained disc herniations that have failed to respond to first line conservative treatment methods. Percutaneous discectomy was designed to minimize or remove the disruptive material surrounding the herniated disc that is believed to be causing the spinal pain and inflammation. Once the disruptive material is removed, patients often report decreased pain and reduced pressure on the spinal nerves. The success rate of percutaneous discectomy is over 80%.

How Is Percutaneous Discectomy Performed?

In an effort to help patients remain calm during a percutaneous discectomy, a sedative is often administered prior to the procedure. The patient is placed on a treatment table on their stomach and the affected area is then anesthetized with a local anesthetic. Once there is sufficient numbing of the area, a probe or needle is inserted, using fluoroscopy, through the skin and into the affected intervertebral disc. Heat or radio waves are then used to minimize the size of the disc and to remove any disruptive disc tissue. By removing the disruptive disc tissue, the pressure within the intervertebral disc is reduced and the patient usually reports pain relief. Once the procedure is completed, the patient is moved to a recovery area to be monitored for adverse reactions.

The percutaneous discectomy procedure is relatively quick to perform, taking approximately 30 minutes in an outpatient environment. Patients can usually leave the facility within three hours after the procedure is complete. Patients may experience injection site tenderness for a couple of days following the procedure and it is recommended that they apply ice or heat to the area to manage their discomfort.

Some patients may be prescribed pain medication to help manage their pain after the procedure. It is advised that patients rest and minimize activity levels for approximately 24 hours after the procedure. Most patients can resume normal activities within one week of the procedure.

The percutaneous discectomy procedure was developed to address the underlying condition of a patient’s pain in addition to reducing their pain. The benefits of a percutaneous discectomy procedure include:

  • Less invasive than surgery
  • Decreased pain
  • Increased mobility
  • Less scarring and fibrosis than alternative treatment options

Percutaneous discectomy is a minimally invasive procedure that can be offered to patients who suffer from chronic back pain resulting from disc herniation that has been non-responsive to conservative treatment options. Although this procedure is considered safe, just like all medical procedures, there are side effects associated with this treatment, including injection site tenderness, increased intracranial pressure, spinal cord compression, infection, bleeding, and hematoma. These risks can be minimized by utilizing sterile techniques and fluoroscopic guidance.

Conditions Related To Percutaneous Discectomy

Suitable candidates for percutaneous discectomy are those who have chronic discogenic back pain that has been unresponsive to conservative treatment options including heat, ice, specific exercises, as well as pain and anti-inflammatory medications. Before patients consider invasive surgical procedures, percutaneous discectomy should be recommended.

Patients who have limited mobility secondary to osteoporosis or other degenerative forms of disease may also benefit from percutaneous discectomy. These patients may experience decreased pain as well as improved mental health following the procedure.

Conclusion

Percutaneous discectomy is a safe, minimally invasive procedure that has been proven to be effective for treating chronic discogenic back pain that has been unresponsive to conservative treatment methods. Patients who have a contained disc herniation are ideal candidates for this procedure. However, those who have limited movement due to osteoporosis or degeneration may also benefit from this procedure. There are limited risks associated with percutaneous discectomy and recovery time following the procedure is relatively quick. These benefits make percutaneous discectomy an ideal option to offer to patients, especially those who are faced with high dose narcotics or surgery for pain management.

References

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