Treatments ~ Discectomy
Lumbar Percutaneous Discectomy
A lumbar percutaneous discectomy may be performed to remove herniated disc material that is pressing on nerves or the spinal cord. The goal of a lumbar percutaneous discectomy is to decompress the nerves by removing deviated disc material and disc fragments. It is a minimally invasive procedure that involves making a very small incision and inserting a tiny surgical needle between the vertebrae, into the middle of the disc. Disc material is removed and as a result, painful nerve pressure is relieved.
Discs are the cushions between the vertebrae of the spine. Each disc is composed of an exterior shell of tough cartilage, and a center of softer, more gelatinous material. Through aging, normal wear-and-tear or injury, the disc may bulge between the vertebrae. If it herniates (ruptures), it can cause severe pain by putting pressure on adjacent nerves, and decompression surgery may be required.
Candidates for a Lumbar Percutaneous Discectomy
A lumbar percutaneous discectomy may be a treatment option for patients with ongoing back or neck pain; sciatica, which involves radicular pain (traveling down the leg); or spinal stenosis, a condition in which the spinal canal has narrowed to the point that it is pressing on the spinal cord. Patients may become candidates for this procedure when more conservative treatment methods such as exercise, medication, physical therapy or chiropractic treatment have failed to resolve symptoms after a period of 4 to 6 weeks. A lumbar percutaneous discectomy may also be considered if the patient has experienced severe pain, and symptoms have interfered with performing normal day-to-day activities.
Benefits of a Lumbar Percutaneous Discectomy
There are many benefits to a lumbar percutaneous discectomy. The procedure is a relatively simple one, and provides rapid relief from pain for the great majority of patients. It is minimally invasive, so involves little scarring or pain. The lumbar percutaneous discectomy is advantageous over other procedures because it:
- Provides tissue for biopsy
- Causes no thermal (heat) damage to the nerve root
- Controls the amount of material aspirated
- Allows for customization of each procedure
Carrying less risk than other types of spinal surgery, a lumbar percutaneous discectomy also allows for more rapid recovery.
The Lumbar Percutaneous Discectomy Procedure
When determining if a lumbar percutaneous discectomy is an appropriate treatment option, the physician must first confirm that the painful symptoms are caused by a bulging or herniated disc. Imaging and diagnostic tests such as an MRI or CT scan, myelography, or discography may be performed to confirm a diagnosis. If a herniated disc is indeed causing pressure on a nerve, then a lumbar percutaneous discectomy is an appropriate treatment option.
Prior to the procedure, patients are sedated and either local or general anesthesia is used. A small incision is made and X-ray images are used to guide the movement of the needle and surgical instruments. The disc tissue is either extracted through a needle or burned or evaporated with a laser. When the targeted matter is removed from the herniated discs, pressure on the nerves in the area, and the pain caused by that pressure, are both relieved. The lumbar percutaneous discectomy takes, on average, about 30 to 45 minutes to perform.
Risks of a Lumbar Percutaneous Discectomy
While a lumbar percutaneous discectomy is considered a minimally invasive and safe procedure, as with all types of surgery, there may be risks which, although rare, include:
- Reaction to anesthesia
- Spinal cord compression
- Excessive bleeding
- Failure to remove all targeted disc tissue
If all of the disc tissue is not removed, there is a chance that the pressure on the nerve will continue and symptoms will persist.
Recovery from a Lumbar Percutaneous Discectomy
Patients can return home the day of the procedure. Pain medication may be prescribed to control pain during the recovery period. After a lumbar percutaneous discectomy, patients should avoid long periods of sitting, as well as bending, twisting, and lifting, for several weeks. In some cases, physical therapy is necessary to help the patient develop greater strength in the back or legs, in order to prevent a reoccurrence of the problem. Most patients experience positive results from a lumbar percutaneous discectomy and have significant pain relief, which allows them to become active again and resume their normal daily activities.