What is Percutaneous Disc Decompression: Procedure, Recovery, Benefits, Risks, Who is a Candidate?

What is Percutaneous Disc Decompression?

Relieving disc herniation by decompressing the disc nucleus is a proven technique for treating the pain symptoms that it causes. Removing some tissue from the center of the disc causes reduction in pressure within the disc. This works somewhat similar to letting air out of a bicycle tire. This, in turn, leads to a reduction in the pressure that the disc applies to other parts of the body, such as nerve roots or the spinal cord.

In July of 2000, the US Food and Drug Administration (FDA) approved Nucleoplasty™ (aka: Percutaneous disc decompression), as a treatment intervention for small contained disc herniations.

The usual treatment for a herniated disc includes a trial of various analgesics, muscle relaxants, physical therapy, and rest. Most patients get significant relief from such treatments; however, this method has some risks involved like gastrointestinal tract bleeding and other complications from analgesics. Moreover, the symptoms eventually return.

Percutaneous disc decompression is a new technique to treat herniated disc. The patients who benefit most from percutaneous disc decompression are those with a contained herniated disc, a disc that has not ruptured and still contains the gel-like material inside it.

What is Percutaneous Disc Decompression?

Who is a Candidate for Percutaneous Disc Decompression?

If you are suffering with discogenic back pain, you possibly may benefit from percutaneous disc decompression. Again, your surgeon will take a call if you are a candidate for percutaneous disc decompression or not by performing different imaging studies and confirming if this is the best option for you.

It is always advisable to undergo conservative measures before opting for surgical treatment for disc herniation. Only if after six months, conservative treatments have not been successful, your spine specialist should consider an intradiscal procedure.

How is Percutaneous Disc Decompression Performed?

Percutaneous disc decompression uses a minimally invasive catheter to create an accurate 1 mm pathway into the disc.

To perform percutaneous disc decompression, also referred to as Nucleoplasty, a micro-engineered alloy transmitter is inserted into the disc while the patient is awake. This requires only a topical anesthetic and light sedation. Radio wave signals are sent through the transmitter into the jelly-like nucleus of the herniated disc. These radio waves produce a low-temperature ionized gas that breaks up molecular bonds in the spongy nucleus, removing tissue volume.

Normally, the entire procedure of Percutaneous Disc Decompression or Nucleoplasty takes 20 to 30 minutes. The patient is ready to walk out of the clinic in about an hour, with no hospital stay required. Disc decompression is a minimally-invasive alternative to open surgery and is designed to offer a fast-acting option to drug therapies and steroid injections.

Some forms of disc decompression are performed through a minimally-invasive catheter or needle. This type of procedure performed through the skin, or percutaneously, minimizes trauma to the patient and allows for faster recovery than traditional open surgical techniques.

Recovery Period Following Percutaneous Disc Decompression or Nucleoplasty

Recovery in percutaneous disc decompression is individualized. Physical therapy typically follows the procedure. People typically return to their prior activity levels within 1 to 6 weeks following percutaneous disc decompression.

Most patients tolerate percutaneous disc decompression or Nucleoplasty fairly well. However, you may experience an increase in your typical pain (back, back and leg) after procedure. It usually subsides over the first 1-14 days following percutaneous disc decompression.

After percutaneous disc decompression surgery, the disc typically returns to its more natural shape as the source of irritation is either eliminated or minimized allowing to patient to resume their life.

Benefits of Percutaneous Disc Decompression

  • Significant relief from pain with minimal invasive.
  • No hospital stay
  • Minimal use of pain medication
  • No general anesthetic
  • Return to previous levels of activity
  • Fast acting
  • Quantifiable disc material removal
  • Less scarring
  • Quicker recovery periods, generally 3-5 days
  • Less chances of complication
  • Outpatient procedure requiring only local anesthetic alleviates possible complications of open surgery and general anesthesia

Percutaneous disc decompression uses an FDA cleared device to decompress contained herniated discs and its related pain symptoms. This is a clinically proven technique with over 10,000 patients treated. The radio wave technology used in disc percutaneous disc decompression is a clinically proven technology.

Risks of Percutaneous Disc Decompression

Risks of Percutaneous disc decompression include infection of the disc, epidural abscess, reflex sympathetic dystrophy, nerve root injury, and injury to retroperitoneal structures.

Before the Procedure

Herniated disc is confirmed by imaging studies like MRI and CT. These tests help recognizing level of the herniated disc and if the decompression method is appropriate for the patient or not. You need to discuss the following thing before you decide about the surgery.

  • Current medications, including herbal medicines and supplements
  • Iodine, drug, or latex allergies.
  • Current health conditions.

Your healthcare provider may ask you to do the following:

  • Abstain from aspirin, ASA-containing products (including Alka-Seltzer® or Pepto-Bismol®) and herbal remedies for at least 5 days before the procedure
  • Abstain from ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDS) for 3 days before the procedure
  • Abstain from eating or drinking for at least 6 hours before the procedure, except necessary medications with sips of water
  • Wear loose-fitting clothes that are easy to take off and put on
  • Arrange for someone to drive home after the procedure is complete

Chronic back pain is fast becoming one of the major debilitating ailments in modern society, with its own social and financial consequences.

Percutaneous disc decompression appears to be safe and effective. Randomized, controlled studies are required to further evaluate its long-term efficacy.

Disc decompression has been proven to be an effective way to get relief from this pain with several benefits. Percutaneous disc decompression procedure is typically performed on an outpatient basis and requires only local anesthetic and mild sedation, alleviating the possible complications of open surgery and general anesthesia. This invasive procedure completes the continuum of care for patients who want a minimally invasive alternative to surgery. Your healthcare provider will help you to decide whether you are an appropriate candidate for Percutaneous disc decompression or Nucleoplasty or not.

Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:January 23, 2018

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