Our spinal columns are made up of bony vertebral columns. There are rubbery cushions between the vertebrae called intervertebral discs which absorb shock and stress that arise during movement. When an intervertebral disc herniates, the disc's interior begins to protrude further into the spinal column, exerting pressure on surrounding nerves and creating discomfort in the legs, back, arms, or neck.
A percutaneous discectomy procedure removes a portion of a herniated disc, providing pain relief.
The LAMIS Institute in Los Angeles offers a variety of herniated disc treatments. Our specialists can assist you in figuring out whether a minimally invasive procedure is the best course of action for you once they have a solid understanding of your exact medical condition and lifestyle habits.
Percutaneous Discectomy: A Quick Overview
A percutaneous discectomy is a procedure that is performed to extract a portion of a herniated disc that's irritating a nerve root, resulting in immediate pain alleviation. Percutaneous refers to "through your skin" or "through a small incision."
Percutaneous discectomy is an alternate option to open surgery. Percutaneous discectomy therapy is most commonly utilized for those who suffer from sciatica, which is a condition that is treated by surgically extracting a section of the vertebral disc.
The purpose of this procedure is to perform decompression on the disc and relieve the strain on the nearby nerves. This procedure can also be beneficial for patients who suffer from other types of physical pain as a result of a herniated disc.
Percutaneous Discectomy can be beneficial to individuals who suffer from a contained herniated disc. This procedure can be successful in assisting to reduce discomfort and enhance mobility provided the outer walls are not ruptured.
It is often designated for patients who haven't had luck with conservative interventions such as prescription drugs, physiotherapy, or nerve blocks. Since the bulged disc is so tiny, patients are generally not eligible for surgery.
Percutaneous discectomy could be performed if any of the following conditions exist:
- The physical exam, history, and imagery (CT scan, MRI, or myelogram) all show that the discs are bulging but that the substance within the disc has not erupted into the spinal column
- Nerve damage and pain have not resolved after four weeks of nonsurgical intervention, and the symptoms are acute and debilitating
- There are indications of severe nerve injury in the leg, including extreme weakness, or sensory loss
- Pain is excruciating and incapacitating
This surgery should not be performed if you have:
- Disc material (or nucleus) fragments inside the spinal column
- Spinal canal narrowing (spinal stenosis)
History of Percutaneous Discectomy
Percutaneous therapies for decompressing intervertebral discs have been used since the 1960s. Initial treatments showed decisively that percutaneous discectomy efficiently alleviates pain in eligible patients. Because of the limitations of early techniques, several sophisticated ways have been devised over time.
To date, the most advanced method of percutaneous discectomy has used plasma technologies to extract tissues from the middle of the intervertebral disc. For the technique, a needle is used to insert an instrument into the middle of the vertebral disc, where several openings are made to extract tissues from the core.
The disc is decompressed by removing tissues from the nuclei, which also releases the disc's pressure on the surrounding nerve roots.
Pain is lessened as pressure is removed, which is similar to the clinical outcomes of previous percutaneous discectomy techniques. There is less tissue trauma, and also many patients could experience faster recovery rates.
Despite the absence of long-term statistics, early trials indicate sustained pain alleviation for up to a year, with patients' first levels of pain remaining unchanged. An increasing body of research shows that pain alleviation lasts for at least two years after surgery.
Who is the Ideal Patient?
In the US, back pain is a highly common ailment that impacts millions of adults.
Often, back pain could be eased using conservative treatment alternatives such as heat, ice, heat, analgesic medication, non-steroidal anti-inflammatory drugs (NSAIDs), and physiotherapy. Patients with more chronic and severe back pain, on the other hand, are frequently treated using opioids and surgical intervention.
Herniated discs are among the most prevalent sources of back problems, which lead to long-term and occasionally severe pain. A vertebral disc is made up of two layers: an innermost layer (also called the nucleus pulposus) and an outermost layer (referred to as the annulus fibrosus).
When the outermost surface of the disc deteriorates, it allows the innermost layer to press outward. The bulging inner layers could irritate or press on nearby spinal nerves, causing extreme back pain.
Conservative treatments are rarely effective for patients who experience back pain induced by herniated discs. Over the past ten years, a wide variety of treatments have been created to give these individuals non-invasive therapy options as opposed to invasive procedures. One of the advancements has been percutaneous discectomy.
Patients with disc herniations who haven't responded to traditional treatment methods are offered the choice of the minimally invasive procedure, percutaneous discectomy.
This surgery aims to reduce or get rid of the tissue that is believed to be generating inflammatory symptoms and back pain in the herniated disc.
Patients typically report pain relief and reduced pressure on the adjacent spinal nerves once the materials are removed.
What is a Herniated Disc?
A herniated disk is an issue associated with the soft, rubbery discs that lie in the space between the vertebral column.
Discs serve as shock absorbers by separating and supporting the spinal cord. Every disc comprises a jelly-like center and an outermost layer of hard tissue. When the outermost walls of the disc degrade, a part of the innermost disc could push into the wall, resulting in a herniation.
The nerves leading to the other body parts are situated behind the vertebral discs and could be inflamed or squeezed by the discs.
Herniated Disc Symptoms
Most herniated discs arise in the lumbar region or lower spine. Although lumbar herniated discs are common, the cervical vertebrae have also been documented to have this condition. The common signs of herniated discs include:
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Leg or Arm Pain
typically an indication of a lower spine herniated disc. Patients suffering from a herniated disc in this area will have the most severe discomfort in their thighs, buttocks, and calves.
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Tingly or Numb Sensations
This is a common symptom among patients with herniated discs. This arises in different sections of the patient's body based on the location of the damaged nerves.
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Weakness
The herniated discs have an impact on muscles since they often induce nerve compression. Furthermore, injured nerves impact the muscles with which they are connected, resulting in impairments and weakness.
What Causes a Herniated Disc?
Herniated discs occur naturally due to aging. This age-related deterioration is referred to by medical professionals as disc degeneration. We gradually lose a percentage of the water present in our spines as we get older. The spinal cord becomes stiffer as a result which makes it more vulnerable to tearing or rupture from even mild stresses.
A herniated disc is also more likely to occur as a result of the following factors:
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Genetics
Sadly, some individuals are more susceptible to suffering from herniated discs than others.
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Occupation
Individuals who work in physical labor-intensive occupations are substantially more likely to experience back issues. Also, there is a higher risk for individuals who regularly engage in certain sports. The likelihood of getting a herniated disc is also increased by repeated twisting, pushing, and pulling.
How is the Percutaneous Discectomy Procedure Performed?
The patient receives a sedative before the percutaneous discectomy procedure to stay calm. The patient is positioned on the treatment table in a prone position.
The doctor will next use a tiny needle to administer local anesthesia to numb the region. After the tissue has been numbed, a bigger probe or needle is introduced into the skin and the afflicted intervertebral disc under fluoroscopic guidance.
When the probe or needle is in the ideal position, the herniated disc's size is reduced and any unwanted material is removed using radio or heat waves.
Extracting the disc tissue from the discs reduces disc pressure and offers pain relief. After the procedure has been completed, the patient is sent to a monitoring area where they will be monitored closely.
The percutaneous discectomy procedure is usually carried out as an outpatient procedure and lasts around 30 minutes. Patients are usually able to leave the hospital within the first 3 hours following the treatment.
The site of injection could be sore for 24-48 hours following the treatment. It is advisable to use cold or heat packs to relieve any soreness. In addition, certain physicians advise their patients to use painkillers after the procedure. After the treatment, patients are instructed to take it easy and limit their activity for approximately 24 hours.
While everyone's recovery times differ, most patients can return to their regular jobs and pastime activities in about a week.
Another advantage of percutaneous discectomy would be that it's a minimally invasive alternative to surgery for treating spinal pain brought on by disc herniation. This technique might assist to improve mobility and reduce pain.
Also, compared to other treatment methods, this approach causes less fibrosis and scarring. The percutaneous discectomy procedure was designed to not only relieve pain but also to address the underlying problem.
Even though it is regarded as a safe technique, there could be risks involved with it, as with any other medical procedure.
The most frequent after-procedure side effect is soreness at the injection site. Less common complications include compression of the spinal cord, higher intracranial pressure, hemorrhage, infections, and hematoma. These risks can be reduced by adopting sterile practices and fluoroscopic monitoring during the treatment.
Preparing for the Procedure
This process requires little to no preparation. In fact, during your initial appointment, you may opt to proceed with this operation. The procedure would be explained before you make your final decision.
At your initial appointment, you will be required to provide any reports, CD-ROMs, or films that contain the results of any prior imaging studies (MRI, CT, x-rays). If you don't have recent images, your health professional may recommend having them made before the treatment.
If you drive yourself to the health facility, you'll need someone to drop you off at home after the appointment. You can take the train or a taxi home on your own. Feel free to contact your physician if you're nursing or believe you might be pregnant. If you can, carry your prescription pills to your appointment and discuss any prescribed medication you are taking with our doctor.
During the Procedure
Discectomy is often carried out in ambulatory surgical centers (ASCs) or local surgery facilities, where your physician can provide you with IV sedation and nurse monitoring. Once you get there, you'll get an IV and, if necessary, a little sedative. Your doctor will go over all of the most recent prescriptions, X-rays, MRIs, and reports.
The operation will be carried out under x-ray guidance, known as fluoroscopy, to ensure that the discectomy probe is properly positioned. By removing disc tissue, the discectomy probe can help to reduce the uncomfortable strain on the nerves.
The operation usually takes between 30 minutes and an hour. Your physician will closely monitor your health condition and level of comfort throughout the operation. You would be requested to rest in the recovery room until you're ready to return home.
After the Procedure
- Your doctor will provide you with guidelines for exercises and rehabilitation advice
- Adult supervision is essential for the remaining period due to the sedative effects
- Apply ice on the affected region for 1-2 hours daily for three days
- Prescription drugs may be administered to alleviate pain symptoms
- Pain will be relieved using appropriate follow-up care
- The best combination for your quick recovery is physiotherapy and at-home exercise
What Outcome Should One Expect?
Percutaneous discectomy has been found in studies to reduce pain and medication usage while enhancing function in up to 90% of patients. Since no bones or muscles are damaged during the treatment, recovery is quick, and scarring is minimal.
Most patients get discharged from the hospital within a few hours after their treatment, whereas some can resume their jobs and their regular daily routines within 3 to 5 days. Furthermore, research has shown that percutaneous discectomy has a lower complication rate than open surgical discectomy.
Advantages of a Percutaneous Discectomy
A Dekompressor discectomy is a low-risk therapy option for back and neck pain. The treatment may reduce pain, improve mobility, and do away with the necessity of traditional surgical procedures. This therapy is intended to address the underlying problem rather than just treat the symptoms.
In comparison to other procedures, the process is far less invasive and results in significantly less fibrosis and scarring.
Risks
There's always the risk of encountering complications with every surgical procedure or medication. One of the most common concerns is mild pain at the injection site shortly after the operation.
Other more severe and far less common issues include high intracranial pressure, spinal cord compression, hemorrhage, infection, or hematoma. The use of sterile methods and X-ray placement reduces these specific risks.
Recovery
After the operation, the soreness or discomfort at the injection site should go away in about 48 hours. Your doctor may recommend painkillers, either over-the-counter or prescription, for the first day or two after discomfort, in addition to hot or cold therapy. Allow yourself to relax for a day or two after gradually resuming activity. The majority of patients discover that after a week, they can resume their usual level of activities.
Frequently Asked Questions on Percutaneous Discectomy
Below are some of the frequently asked questions on this procedure.
What is a Percutaneous Discectomy?
A percutaneous discectomy is regarded as a minimally invasive vertebral disc decompression treatment used to address a contained herniated disc located in the neck or back which has not ruptured yet. During this treatment, your physician will use a needle introduced through the skin to perform spinal decompression.
What is the Difference Between Contained and Non-Contained Herniated Discs?
Intervertebral discs found between the spinal discs have a fibrous outermost layer that envelops a gel-like material in the middle. Aging causes spinal discs to lose moisture, become less flexible, and form weak spots or little tears throughout the outermost layer.
A confined herniated disc occurs when the innermost gel protrudes through a weakened location while the outermost layer remains intact. A non-contained disc occurs when the disc tears and the gel leaks out.
What Symptoms Point to a Potential Need for a Percutaneous Discectomy?
A herniated disc could cause back or neck pain based on how the disc is positioned in your spinal cord. When a disc protrudes, it may press against neighboring nerves, resulting in symptoms along the affected nerve.
Patients often report tingly, pain, or burning sensations that travel down their legs or arms. Sciatica most often results from herniated discs. When your sciatic nerve is pinched, you experience an electric-shock sensation that goes down your leg.
How is this Procedure Performed?
A percutaneous discectomy procedure is minimally invasive. To locate the affected disc, the physician uses a technique referred to as fluoroscopy.
The surgeon places a probe into the herniated disc using fluoroscopic imaging instead of cutting into the skin. The surgeon next uses heat waves to dissolve the herniated disc material, which reduces pain and releases pressure on pinched nerves.
This procedure can be conducted under local anesthesia, to lower the risk of complications.
What Spinal Conditions Can be Treated With a Percutaneous Discectomy?
A percutaneous discectomy could help relieve pain caused by herniated discs and accompanying nerve problems like sciatica. If the pain doesn't go away after about six months, surgery could be an option to consider.
There are many types of spinal surgery; your surgeon could counsel you on whether a percutaneous discectomy can help you address your condition.
What Symptoms Necessitate a Percutaneous Discectomy?
The primary treatment option for herniated discs is often non-surgical methods. Therefore, a percutaneous discectomy could be done when:
- You have a herniated disc
- Conservative methods of treatment, such as prescription drugs and physiotherapy, have failed
- There is an indication of nerve compressions, such as radiculopathy or sciatica
- You experience severe pain that interferes with your everyday life
- The debris from the disc herniation is pressing against a nerve
It might not be effective for patients who have severe, uncontained herniations in their spinal column. Additionally, those with stenosis may not always benefit from it.
Your physician might request imaging tests like MRI images to better view the herniated disc and pinpoint the afflicted nerves to determine whether you are eligible to receive a percutaneous discectomy. If you do not qualify as a candidate, the specialist might explore alternative therapies with you.
How Safe is a Percutaneous Discectomy?
A percutaneous discectomy is typically safe and effective. Percutaneous discectomies certainly pose some risk, just like any surgical procedure. Although the dangers are reduced compared to open surgery, they still exist.
- Anesthesia-related responses
- Nerve irritation
- Bleeding
Additionally, there's a chance that the procedure won't be successful and you'll still experience discomfort and pain. There is no way to completely predict the outcome of the procedure.
How Long Does Recovery From Surgery Take?
In comparison to other spinal procedures, the recovery time from a percutaneous discectomy is substantially shorter because it can be conducted under local anesthesia. There's little scarring, and recovery is faster due to the absence of muscle or bone injury.
However, certain activities, such as heavy bending or twisting, should be avoided for several weeks after surgery.
Each surgery is unique. You can ask the specialist to go through any specific rehabilitation or postoperative recovery recommendations with you.
How About If You Do Not Want to Undergo a Percutaneous Discectomy?
It would be best if you didn't worry; sciatica and other disc herniation conditions can sometimes be successfully treated without surgery.
Other surgical therapies are also accessible, based on your medical history, and condition, among other symptoms. The best approach to determine the best course of action for your condition is to speak with a back specialist.
Find a Percutaneous Discectomy Specialist Near Me
At the LAMIS Institute, we use a variety of techniques to treat patients experiencing chronic pain. We assist patients to improve body functioning and maintain a healthy lifestyle while reducing their dependence on opiate drugs by employing comprehensive and cutting-edge treatments.
Call us at 310-734-6088 for more information on percutaneous discectomy or to schedule a consultation. We serve the City of Los Angeles.
