Percutaneous Discectomy

A percutaneous discectomy. also known as a percutaneous disc nucleoplasty, is a minimally-invasive surgical procedure used to treat herniated discs the put abnormal pressure on your spinal nerves. Some forms of the surgery use heat to reduce the size of the intruding disc, while others use controlled radio waves.

Herniated Disc Effects

A herniated disc forms when abnormal stress triggers rupturing or tearing in one or more layers of the disc’s tough outer coating, known as the annulus fibrosus. If all of the annulus layers rupture, the cushioning material in the disc’s interior, called the nucleus pulposus, can leak out and intrude upon nearby nerves emerging from your spinal cord. If only some of the layers tear, movement in the nucleus pulposus can change the shape of the disc and push it past its normal space between your spinal bones. Any intrusion upon your nerves can trigger pain, as well as burning, tingling or other abnormal sensations generated by the nerve tissue.

Percutaneous Discectomy Basics

At the start of a percutaneous disc nucleoplasty, your doctor will numb the site of the procedure with a local anesthetic, then use a live X-ray feed to guide a hollow needle to the disc in your back that’s causing problems. At this stage of the procedure, some doctors insert a device, called a spinal wand, through the interior of the needle. This device removes intruding nucleus pulposus from your spinal nerves and then applies heat to seal up the main body of the disc.  Other doctors insert a device that conducts specialized radio waves. In a procedure called controlled ablation, or coblation, these waves create openings in the interior of the disc; a natural phenomenon, called negative pressure, then draws the herniated nucleus pulposus away from the nerve and into these openings.

Benefits

While a percutaneous disc nucleoplasty can be used on any portion of your spine, doctors most commonly use the procedure to treat herniated discs in the lumbar spine (lower back). When compared to conventional forms of disc surgery, percutaneous disc nucleoplasty presents benefits that include less trauma to your body during surgery, reduced chances of postsurgical complications, and reduced recovery times in the aftermath of surgery. Roughly 70 percent of people who undergo the procedure have at least a 50 percent reduction in their disc-related pain levels.

Risks

Potential risks associated with a percutaneous disc nucleoplasty include infection, damage to local nerves and bleeding that results in additional surgery. The procedure can also fail to ease your disc-related pain or actually worsen your original symptoms. In addition, some people later experience another disc herniation at the procedure site. Generally speaking, percutaneous disc nucleoplasty presents very little risk for serious complications of any kind.

 

References

Massachusetts General Hospital: Nucleoplasty (Percutaneous Discectomy)
MedCentral Health System: Disc Nucleoplasty
Aurora Health Care: Nucleoplasty (PDD – Percutaneous Disc Compression)
University of Rochester Medical Center: Orthopaedics and Rehabilitation – Treatments
American Association of Neurological Surgeons: Herniated Disc