Percutaneous Discectomy - MILD

This is a term used for multiple procedures involving removal of herniated discs that are causing pain by pressing on the spinal cord or nerve roots. The procedure actually leaves the disc in place but removes the material from the center of the disc.

After a local anesthetic is applied to the area, a very small incision is made and a very large needle is inserted into the appropriate area using x-ray technology. Then the “Stryker Dekompressor” will be inserted into the needle to the damaged area.

You will be mildly sedated during the procedure that will allow you to relax. Then there are multiple ways to remove the disc. They can suck out the disc material from the center or they can cut the entire disc out. They can also use lasers to destroy the disc and then remove it.

You should have the procedure if the following conditions apply:

1. You have been diagnosed with a bulging disc that has not ruptured
2. The pain is severe enough to keep you from doing your normal activities. The pain has not gotten any better after 4 or more weeks of trying other non-invasive procedures.
3. If nerve damage in your legs will get worse without the surgery
4. If there is no spinal stenosis present
5. If there is no disc material in the spinal canal

The procedure will be done in an out-patient facility so you should be able to go home the same day. The procedure takes about 15-30 minutes to perform and recovery can be anywhere from 2-3 hours after. You will have some post- operative pain but is should be able to be controlled by prescription pain relievers. For some time after surgery, you will have to sit for only short periods of time and try not to lift, twist or bend too much.

Patients may receive an improvement in pain in more than 70% of the time. The procedure is meant to actually cure the condition behind the pain, not only mask it. Most of the time, 79% of the people who had the procedure were able to return to normal activities because of the reduction in pain. Because of the small incision, the amount of time to return to normal activities is relatively short; approximately 6 weeks.

There are lower risks with this procedure than will regular back surgery. The most common after effects of the procedure is mild pain at the site of the injection for a short amount of time after the procedure. Some less common risks are abnormal bleeding that may require surgery, infection of the spinal cord, extra intracranial pressure, or spinal cord compression. Many of these risks are severely reduced by the use of sterile equipment to lessen infection and x-ray machines for appropriate positioning of the needle.

Hu SS, et al. (2006). Disorders, diseases, and injuries of the spine. In HB Skinner, ed., Current Diagnosis and Treatment in Orthopedics, 4th ed., pp. 221–297. New York: McGraw-Hill.

Kim, H., Ju, C., Kim, S., & Kim, J. (2009). Huge Psoas Muscle Hematoma due to Lumbar Segmental Vessel Injury Following Percutaneous Endoscopic Lumbar Discectomy. Journal Of Korean Neurosurgical Society / 대한신경외과학회지, (3), 192.