by Nicole Berardoni M.D., Paul Lynch M.D., and Tory McJunkin M.D.
Percutaneous discectomy, also known as Dekompressor (Stryker), is a non-surgical, effective treatment for back and neck pain associated with herniated disc disease. The pain relief associated with this therapy is due to decompression of the spinal discs and facet joints, thus reducing the pressure exerted onto the spinal cord and nerve roots causing pain (Boswell 2007). Separating each individual spinal vertebrae are discs that act as cushions to minimize the impact that the spinal column receives. Since the discs are designed to be soft and provide support, they have a tendency to herniate posteriorly (bulge backwards) through the outer disc segment and ligaments. These bulging discs can cause irritation to the adjacent nerves. Disc disease is one of the most common causes of chronic neck and back pain and accounts for approximately 10% of all lower back pain complaints. Disc disease may be acute herniation resulting from trauma, or more commonly, from chronic disease. Degenerative disc disease is a process that is due to a thinning and degeneration of the discs over time. Commonly seen, neck and back pain may go into painless remission with periods of decreased or absent symptoms; however, the pain often returns, causing a chronic pain syndrome. If your pain has lasted longer than four weeks or is severe in nature, you should see a pain specialist about treatment options. Ongoing research has hinted that early intervention decreases the incidence of developing chronic pain. Decompression therapy is often considered when the pain has not improved after a month and is radicular, resulting from irritation of the nerve roots.
ProcedurePercutaneous discectomy uses a single-use probe called the “Stryker Dekompressor” which is placed under X-ray guidance. You will be pre-treated with a sedative that will help you to relax, but you will remain awake for the procedure. Before the treatment begins, you will be comfortably positioned on your stomach with your knees supported on the table. Your physician will inject a local anesthetic with a small needle to numb the area. Once the area is numb, a larger needle is placed into the affected disc with X-ray guidance. The probe is placed through this needle, and the procedure is initiated. You may feel pressure during this part of the procedure, but should not experience pain. The Dekompressor uses a pump method to remove excessive disc material from bulging or contained herniated discs, thus reducing pressure in the disc and providing pain relief.
A discectomy using the Dekompressor is a lower-risk treatment option for neck and back pain. The procedure may decrease pain, increase mobility, and eliminate the need for traditional surgical interventions. This treatment is designed to correct the underlying problem, not just relieve the symptoms. The procedure is a minimally-invasive procedure that causes much less scarring and fibrosis than is commonly associated with other interventions. A study reported in 2007 that “discectomy is minimally invasive, safe, and effective for treating disc herniations and that 89% of patients treated by this method stated they achieved successful outcomes from the therapy“ (Tzaan 2007).
RisksAs with all medications and surgical procedures, there is always a risk of complications. With lower risks than traditional back surgery, discectomy is considered an appropriate treatment for many patients who suffer from back pain (Boswell 2007). The most common complaint is mild back pain at the injection site shortly after the procedure. Other more serious and far less common complications include spinal cord compression, excessive intracranial pressure, bleeding, hematoma, or infection. These particular risks are decreased by the use of X-ray and sterile techniques.
OutcomeThe American Society of Interventional Pain Physicians developed a large evidence-based practice guideline for the management of chronic spinal pain with interventional techniques. The 2007 article stated that percutaneous discectomy using the Dekompressor resulted in greater than 70% improvement in pain in 79% of patients undergoing the treatment for postero-lateral disc herniations. (Boswell 2007). The reduction in pain allows patients to experience enough relief to become active again. Often patients regain the ability to resume their normal daily activities. If you are suffering from chronic back or neck pain, contact Arizona Pain Specialists today to see if you can benefit from this advanced treatment.
- Interventional techniques: evidence-based practice guidelines in the management of chronic spinal pain. Boswell MV, Trescot AM, Datta S, Schultz DM, Hansen HC, Abdi S, Sehgal N, Shah RV, Singh V, Benyamin RM, Patel VB, Buenaventura RM, Colson JD, Cordner HJ, Epter RS, Jasper JF, Dunbar EE, Atluri SL, Bowman RC, Deer TR, Swicegood JR, Staats PS, Smith HS, Burton AW, Kloth DS, Giordano J, Manchikanti L; American Society of Interventional Pain Physicians. Pain Physician. 2007 Jan;10(1):7-111 PMID: 17256025
- Transforaminal percutaneous endoscopic lumbar discectomy. Tzaan WC. Chang Gung Med J. 2007 May-Jun;30(3):226-34 PMID: 17760273