Percutaneous discectomy (nucleoplasty) is a minimally invasive treatment for a herniated disc. Numerous patients undergo this procedure for relief of chronic back pain and radiculopathy.
Back pain affects most all adults at some point during their lives. According to statistics, around 2% of the U.S. workforce file compensation claims each year related to back pain.
When the inner gel-like material pushes through the worn external layer of the disc, it is called a herniated disc. This is one of the most common causes of chronic back pain. In addition, the pressure of the herniation can result in inflammation of spinal nerves. If the spinal nerve is irritated, it can produce radiculopathy, which involves leg and foot pain.
The percutaneous discectomy is done to shrink or remove the material surrounding the herniated disc, which then relieves inflammation of the nerve and pain. Once the doctor removes this material, the patient has less pressure on surrounding nerve roots and less pain.
Because a mild sedative is used, be sure to arrange for someone to drive you home. When you arrive at the medical center, a member of the healthcare staff will review the benefits and risks of the discectomy and have you sign a form of informed consent. An IV catheter is placed in your arm to administer fluids, antibiotics, and a sedative. The nurse will attach specific monitoring devices to your arm and finger, so the doctor can check your blood pressure, heart rate, and oxygen levels.
As an outpatient procedure, the percutaneous discectomy only takes about 30 minutes to perform. This involves administering a small needle into the spinal column to remove the herniated disc material. The doctor first cleans the skin and uses an anesthetic to numb the region directly over the disc. A tiny incision is made to introduce the needle into the surgical area. After this, the material is removed using radiofrequency energy, which also diminishes the size of the disc protrusion. When the incision is closed with sutures, a bandage is secured over the surgical site.
Once the percutaneous discectomy is over, the patient is moved to the recovery area where the doctor and assistants monitor pain and vital signs. Once the anesthetic wears off, you will notice tenderness and soreness at the incision site. Use an ice pack on this for 20-minute intervals several times each day for a few days. You cannot soak in a tub or shower for 2-3 days, and should rest the remainder of the procedure day.
Clinical studies show that percutaneous discectomy is 80% effective. This procedure removes material that causes pressure on nerves, so pain is greatly reduced after the surgical area heals. This procedure is a good option for patients who are not candidates for surgery, or for those who refuse to undergo a major spine surgery.
As with other minimally invasive procedures, there are a few risks to consider. These include infection, bleeding, nerve damage, and blood vessel injury. Of course, there is a chance of side effects to the various medications and solutions used during the procedure. Be sure to notify the doctor beforehand of any allergies you may have, such as to iodine, betadine, alcohol, sedatives, antibiotics, and latex.