Percutaneous Discectomy

In the United States, back pain is a common affliction, affecting millions of adults (or roughly 2% of the U.S. workforce). In many cases, conservative treatments can provide adequate symptom relief. These nonsurgical treatments may include ice/heat application, NSAID/pain medication, and physical therapy. While these are all great options for treatment, they unfortunately do not always alleviate symptoms. In patients with severe back pain, a doctor may recommend narcotics or spinal surgery for treatment.

A percutaneous discectomy (PD) is a minimally invasive procedure that doctors use to treat more severe cases of disc herniation. Disc herniation is one of the most common causes of chronic and extreme back pain. This spinal abnormality occurs when the outer layer of a disc deteriorates. Naturally, this structural weakness results in the inner layer being pushed outward, which often irritates surrounding nerves. Usually, conservative treatments are enough to treat disc herniations, but in more severe cases a PD may be more appropriate.

The premise behind a PD is to eliminate pain by shrinking or removing the material surrounding the slipped disc. Surgeons remove this material because the disc fragments often cause both pain and inflammation. Naturally, the removal of this material leads to pain relief and less pressure on the spinal nerves. PDs have a very high success rate, alleviating symptoms for patients over 80% of the time.

Symptoms of a Herniated Disc

The majority of herniated discs occur in the lumbar spine, or lower back. While lumbar disc herniation is typical, herniated discs have also been known to occur in the cervical spine, or neck. The most common signs and symptoms of herniated discs include:

• Arm or leg pain: Usually indicative of a herniated disc in the lower back. Patients with a herniated disc in this region will feel the most extreme pain in their thigh, calf, and buttocks.
• Tingling or numbness: A very common symptom that patients experience when they have a herniated disc. This occurs in different parts of the body depending on where the affected nerves are located.
• Weakness: Herniated discs affect muscles because they often result in nerve compression. And, the damaged nerves naturally affect the muscles to which they connect, resulting in impairment and weakness.

Causes of a Herniated Disc

Disc herniation usually occurs as a natural result of the aging process. Medical experts refer to this age-related wear and tear as disc degeneration. As we age, we lose some of the water content that exists within the spine. As a result, the spine becomes more rigid and is more likely to tear or rupture under even minor pressures.

Factors that increase the risk of a herniated disc are as follows:

• Genetics: Some people are unfortunately more predisposed to developing herniated discs than others.
• Occupation: People with jobs that involve hard physical labor are at a much greater risk of back problems. Additionally, those who regularly participate in certain sports are also at a greater risk. Likewise, repetitive twisting, pulling, and pushing all increase the chance of developing a herniated disc.

How is a Percutaneous Discectomy (PD) Performed?

Prior to the procedure, the patient receives a sedative and a local anesthetic to combat pain and stress on the body. The surgeon then positions the patient face down to make the affected site easily accessible. Once the surgical site is numb, the surgeon inserts a bigger needle through the skin into the target area via a fluoroscopic instrument.

With the needle in place, the surgeon uses heat waves to reduce the disc size and remove disruptive material. In a vast majority of herniated disc cases, removal of disc material leads to reduced pressure in the vertebral column as well as pain relief. Once the needle insertion site has been closed and the procedure is complete, the patient is moved to a recovery area for monitoring.

A PD normally takes about 30 minutes to perform and can be completed on an outpatient basis. In virtually all cases, patients are able to return home within one to three hours after their surgery. For the first 24-48 hours, the injection site may feel sensitive. To ease with this discomfort, the patient should apply heat or cold packs as needed and advised. If necessary, your physician may prescribe pain medication to take as directed following the PD. In addition, it is advised that the patient rest for the next 24 hours to ensure the smoothest recovery possible. Although recovery times vary on a case-by-case basis, most patients find that they are able to return to normal activities within a week.