Percutaneous Discectomy is an outpatient procedure used primarily to treat the pain that may result from a disc herniation or disc bulge in the spine. A discectomy is the partial removal of a herniated disc, and the word percutaneous means that it passes through the skin. Removing the disc in this way can help to relieve the pressure on the nerves, which is usually the source of the pain, sciatica, or lumbar radiculopathy experienced by the patient.
Discectomy is a surgical procedure that has been used for decades to treat herniated discs in the spine when non-surgical treatments are ineffective. In recent years, this procedure has undergone an evolution from a traditional surgery to a minimally invasive surgery that can be performed on an outpatient basis on patients for whom spine surgery and general anesthesia may not be possible.
In the traditional method, an incision is made in the back, near the disc herniation, and the disc is removed manually with a scalpel and forceps. Newer methods use smaller incisions, and only a needle and a probe are required to extract the discs. In addition, an advanced technique known as nucleoplasty can be used to treat a disc bulge. This method requires heat or radio waves to reduce the size of the disc.
Percutaneous discectomy may be indicated for patients with a history of contained, localized bulging or herniated discs. Percutaneous discectomy is considered if epidurals fail to provide pain relief. If the pain, sciatica or lumbar radiculopathy has not improved after the non-surgical treatments, and symptoms are preventing the patient from conducting normal activities, then percutaneous discectomy may be performed. Percutaneous discectomy is not indicated for patients who have ruptured discs that have been forced into the spinal canal.
During the Procedure the patient is given a local anesthetic after lying face down on the operating table. A sedative may be administered in conjunction with the anesthetic to increase its effectiveness and reduce anxiety. The pain management doctor makes a small puncture with a probe or needle through the skin near the herniated disc. Portions of the disc are then cut away and suctioned out of the body under live fluoroscopic imaging. The entire procedure takes about 15 minute to complete.
After the surgery, patients may feel mild pain but are usually discharged after a short period of observation. Patients may also experience dizziness or fatigue, so they should not drive home themselves. For two to three days after the operation, patients should receive plenty of rest, and normal activities can usually be resumed the following week.