Severe lower back pains affect 80 percent of people at some point in life. One of the reasons why back pains become chronic or severe is the fear of treatment itself. When an acute injury becomes chronic, a patient may hesitate to seek medical attention because of their fear of undergoing surgery. Luckily, various less invasive treatment options are available, which are just as successful as surgical procedures. Percutaneous lumbar discectomy is an example of these options.
At LAMIS Institute, we boast a wide range of treatment options for lower back pains. After understanding your lifestyle and medical situation, we can assist you in deciding if percutaneous lumbar discectomy is best for you. If it is not, we will recommend an alternative procedure that can achieve the best possible outcome. If you wish to treat your back pain in Los Angeles, please do not hesitate to contact us for a consultation. Here is what you need to know about percutaneous lumbar discectomy and its possible benefits.
Percutaneous Lumbar Discectomy Overview
Generally, healthcare providers have used open surgery (for example, incision) to cure sciatica by taking out part of the intervertebral disc to achieve decompression and alleviate the pressure the disc is exerting on the surrounding nerve roots. Generally, people who require a decompression surgical procedure suffer from leg pain or sciatica caused by a slipped or herniated disc.
The techniques for disc decompression surgery have since advanced. Nowadays, the procedure is conducted through endoscopes and even through tiny incisions— all performed with a microscope or resembling technology to view the surgical access into the disc.
However, even lesser invasive techniques are available for some people, where the whole decompression is conducted percutaneously using a needle. Patients who could benefit from percutaneous lumbar discectomy suffer from pain from a herniated disc.
Disc herniation occurs when the outer layer of a disc deteriorates and is among the most prevalent causes of chronic back pains. Usually, disc herniation leads to the inner disc layer being pushed outward, often irritating the surrounding nerves. Signs and Symptoms of disc herniation include leg or arm pain, numbness or tingling, and weakness. Conservative treatments are usually sufficient to treat herniated discs, but a percutaneous lumbar discectomy could be more appropriate in highly severe cases.
The percutaneous lumbar discectomy is a procedure to extract herniated disc matter pressing on the spine or nerves. This procedure aims at decompressing nerves by extracting disc fragments and herniated disc material. It is minimally invasive and entails making a small cut and placing a needle between the vertebrae into the middle of the disc. The doctor then removes disc material, relieving pressure in the nerves and ultimately alleviating pain.
Discs are cushion-like materials between spinal vertebrae. The outer part of these discs comprises a shell of hard cartilage, and the center part is composed of softer and more glutinous matter. The disc can bulge between the spinal bones through injury, wear & tear, or aging. If it ruptures (herniates), it can lead to severe pain since it will exert pressure on surrounding nerves, resulting in the need for percutaneous lumbar discectomy, also called decompression surgery.
Who Is a Suitable Candidate for Percutaneous Lumbar Discectomy?
The percutaneous lumbar discectomy procedure can be a suitable treatment option for patients suffering from:
- Neck or back pain.
- Spinal stenosis - a spinal canal narrowing to the extent it presses on the spine.
- Sciatica - a condition involving radicular pain moving down the leg.
You may be eligible for percutaneous lumbar discectomy when conservative techniques like medication, exercise, chiropractic treatment, or physical therapy have not successfully relieved symptoms after four to six weeks. You may also consider percutaneous lumbar discectomy if you have had severe pains and your symptoms have prevented you from performing the usual daily activities.
Why Percutaneous Lumbar Discectomy Is Done
Percutaneous lumbar discectomy is performed to decrease pain and enable you to regain your normal function and movement. Your doctor may consider this surgery if:
- You have severe numbness, weakness, or leg pain that prevents you from being capable of doing your day-to-day activities.
- Physical examination results show you have an abnormal feeling, loss of motion, or weakness that will likely improve after surgery.
- Your leg symptoms do not improve after at least six weeks of nonsurgical treatment.
- Physical exams, imagery (MRI, myelogram, or CT scan), and history show the discs are bulging, although the substance in the disc has not erupted into the spinal column.
Percutaneous lumbar discectomy surgery is an emergency if you have cauda equina syndrome. Symptoms include:
- New tingling or numbness in the genital area, buttocks, or legs (often both legs).
- New weaknesses in the legs (often both legs).
- New loss of bladder or bowel control.
When to See a Doctor
Percutaneous lumbar discectomy is a less invasive surgical procedure with an exceptional track record of alleviating pain. Whereas most people experiencing sciatica do not need surgery, a percutaneous lumbar discectomy may be the ideal option if other treatment options fail.
Your physician will assess your situation and establish whether the procedure best suits your needs. If you are eligible for the surgery, you should discuss its benefits and risks with your healthcare provider.
The Procedure
When establishing whether a percutaneous lumbar discectomy is a suitable treatment procedure, the doctor must first ascertain that the pain and other symptoms result from a herniated or bulging disc. They may perform diagnostic and imaging tests like a CT scan, MRI, discography, or myelography to verify a diagnosis. If the pressure on your nerve results from a ruptured disc, a percutaneous lumbar discectomy procedure is a suitable treatment option.
Before the procedure, the doctor will sedate you and administer either general or local anesthesia. They will then make a tiny incision and use x-ray images to guide the surgical instruments and needle's movement. They will either extract the disc material through a surgical needle or evaporate or burn it using a laser.
Once the doctor removes the targeted material from the ruptured discs, the pressure in the nerves around the area and the pain resulting from that pressure are relieved. The procedure generally takes thirty to forty-five minutes to complete, and you can leave the recovery room with only a small bandage over the needle insertion site.
Preparing for Percutaneous Lumbar Discectomy
Ask your doctor how you should prepare for your surgery. Ask them if you ought to stop taking any medications ahead of time, such as blood thinners. Do not drink or eat after midnight the night before your surgery. Your doctor may order other imaging tests of your spine, like MRI.
Recovery from Percutaneous Lumbar Discectomy
You can return home the day you underwent the procedure. The doctor may prescribe pain medication to suppress pain while you recover. After the procedure, you should avoid driving or sitting for an extended period and lifting heavy stuff, twisting, and bending for many weeks. In certain cases, you may require occupational therapy and physiotherapy to help you develop more strength and flexibility in the legs and back to prevent the problem from recurring.
Most patients have positive results after a percutaneous lumbar discectomy and experience significant pain relief, allowing them to be active again and return to their usual daily activities.
What to Expect After the Procedure
After the procedure, you are encouraged to walk as soon as the numbness wears off. While you recover, you could slowly return to your exercises and other daily activities. The following are other things you can think about:
- If yours is office work, you can resume work in one or two weeks. If your work entails physical labor (like operating vibrating machinery or lifting), you can resume work four to eight weeks after the procedure.
- Most people can resume work and daily routine soon after the procedure. In certain cases, your physician may recommend a rehab program that might include home exercises and physical therapy.
- Walk as often as you can for the first several weeks. Walking around often will assist you in lowering the risk that plenty of scar tissue will develop.
- You might feel uncomfortable sitting initially. However, sitting will be more comfortable with time.
Benefits of Percutaneous Lumbar Discectomy
Percutaneous lumbar discectomy comes with many benefits. This procedure is relatively straightforward and provides quick pain relief for most patients. It is less invasive and thus involves little pain or scarring. A percutaneous lumbar discectomy is beneficial over other treatment procedures as it:
- Allows for customization of every procedure.
- Controls the quantity of aspirated material.
- Causes no heat (thermal) damage to the roots of the nerves.
- Provides tissues for biopsy.
- Carrying minimal risks than other spine surgeries, a percutaneous lumbar discectomy enables the patient to recover more rapidly.
Risks of Percutaneous Lumbar Discectomy
Whereas percutaneous lumbar discectomy is deemed a less invasive, safe procedure, it may have risks, just like all other surgical procedures. Although these risks are rare, they include the following:
- Failure to extract all targeted material. If all the disc material is not extracted, chances are high that the nerve pressure will continue and symptoms persist.
- Infection.
- Excessive bleeding.
- Compression of the spinal cord.
- Reaction to anesthesia.
- Blood clots.
- Injury to neighboring nerves.
- Only temporary (short-term) relief and the necessity for another surgical procedure.
- Dural tear (cerebrospinal fluid leak).
These risks vary based on the patient's general health and age. Speak with your doctor about what risk most applies to your case.
How much Does Percutaneous Lumbar Discectomy Cost?
A percutaneous lumbar discectomy is a specialized procedure that needs a specially trained surgeon. Due to this fact, it can be more expensive than other back surgical procedures. The cost varies and can range between $15,000 and $50,000. This cost may be exclusive of any follow-up care or visits. Your insurance might cover a significant part of this cost after you pay your coinsurance and deductible.
If you do not have insurance, ensure you talk to your surgeon, hospital, and all other healthcare professionals before undergoing treatment. Inquire if you can negotiate a lower rate since you are paying from your pocket.
Percutaneous Lumbar Discectomy Vs. Traditional Discectomy
Percutaneous lumbar discectomy and traditional discectomy differ slightly as traditional discectomy techniques can use traditional graspers, lasers, camera-assisted visualization, suction devices, and other modern or high-technology sounding instruments. Ultimately, The goal is the same— extracting the slipped disc material.
Unluckily, percutaneous lumbar discectomy is not as straightforward as it appears. For several reasons, the result of this procedure is less predictable than most healthcare providers would like. Percutaneous lumbar discectomy is usually considered in cases where the case of the herniated disc is not significant, and the findings of the physical exam are not definitive. The procedure is considered less invasive, therefore, a less risky treatment option. Due to this reason, most patients who would usually not opt for open-incision surgical procedures will go for this option.
Healthcare providers know that patients with significant disc herniation and the perfectly resembling physical exam findings of corresponding weakness, reflex changes, and numbness will record the best predictable results. In this case, traditional open incision surgery (microdiscectomy) will be the procedure of choice, recording the best outcome.
A percutaneous lumbar discectomy is an option for less predictable cases and, therefore, those with a less predictable outcome. Additionally, there is the subject of knowing whether the pain-causing disc matter has sufficiently been extracted since the visualization is usually not always optimal. Most people do not know that the perceived low risk of percutaneous lumbar discectomy does not consider the likelihood of continued pain after the procedure.
Find a Neurointerventional Surgeon Services Near Me
At LAMIS Institute, we treat patients suffering from chronic pain with several therapies, including less invasive techniques such as percutaneous lumbar discectomy for back pain. Using a detailed approach and the most advanced therapy techniques, we work hand in hand with patients to restore function and regain an active lifestyle while minimizing the need for pain medications. If you seek treatment for your back or neck pain in Los Angeles or want to learn more about our procedures, call us at 310-734-6088 to set up an appointment.
