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.
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:
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:
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.
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PDs are a minimally invasive procedure and naturally carry benefits associated with improved surgical techniques. In fact, most forms of minimally invasive surgery boast very similar benefits, including:
While minimally invasive surgeries are a great treatment option for some, in other cases they are simply not viable. You will need to consult with your doctor to see if a PD is right for you. Additionally, just because the risk of complication is lower does not mean that there are no risks. As with any surgical procedure, there are always possible side effects. Although they are rare, side effects of PDs consist of:
Again, it is important to note that these reactions are quite rare. In the vast majority of cases, PDs go off without a hitch and help to alleviate symptoms tremendously. Additionally, these risks are often further minimized through pre-surgery medical screenings and x-ray guidance.
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Whether or not you qualify for a PD will depend on a variety of factors about your case and medical history. Before any surgery, doctors will often perform a medical evaluation and ask you a series of questions about your symptoms. This is usually when it is decided whether or not a PD is a good fit, considering your case and any pre-existing medical conditions.
The most ideal patients for a PD are those who suffer from chronic back pain, more specifically pain caused by disc herniation. If the patient has not responded to more conservative herniated disc treatments like the ones listed near the beginning of this reading, then surgery is considered. Additionally, patients suffering from osteoporosis or degenerative disc disease may also find relief from a PD. For these patients, a PD may also improve mental and physical health following the procedure.
Minimally invasive surgeries are often considered first before more traditional open surgeries. This stage will heavily depend on how you communicate with your doctor so be sure to give concise, accurate information.
Do you have chronic back pain that is not responding to conservative treatments? If so, give us a call at (855) 586-2615. NJ Spine & Orthopedics has a dedicated team of back pain doctors in New Jersey who specializes in state-of-the-art and minimally invasive spine surgeries. Additionally, we provide all patients with individualized care plans that are tailor-made to suit their specific needs.
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