Serious lower back pain affects 80% of people in their lifetime. One reason back pain becomes serious or chronic is fear of treatment itself. When acute injuries become chronic, patients may hesitate to seek treatment for fear of a surgical intervention. Fortunately, there are minimally-invasive options that can be just as effective as surgery. Percutaneous discectomy is one such procedure. Here’s what you should expect about this procedure and its potential benefits.
When would I need percutaneous discectomy?
Percutaneous discectomy, also known as Dekompressor (Stryker) procedure, is a non-surgical, effective treatment for some forms of back and neck pain.
Your spine consists of vertebrae stacked on top of each other. Between each vertebra are intervertebral discs. These are soft, fluid-filled cushions that ease movement and provide shock absorption for the spine. The facet joints connect each vertebrae, and various ligaments and tendons further stabilize the spine. The spinal cord runs through this whole anatomy, down the middle of your spinal column from the bottom of the spine to attach at the skull.
When every part of the spine is healthy, it is a beautiful, supportive structure. When things go wrong, however, the pain can be debilitating.
Due to disease, age, or injury, an intervertebral disc can be taxed beyond its ability, forced out from in between the vertebrae it is intended to cushion. Since the discs are designed to be soft and provide support, they have a tendency to bulge backwards through the outer disc segment and ligaments. These bulging discs can cause irritation to the adjacent nerves.
Neck and back pain may go into painless remission with periods of decreased or absent symptoms; however, the pain often returns, leading to 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.
Early interventions and treatments decreases your chances of developing chronic pain. Decompression therapy is often a choice when your pain has not improved after a month and is radicular (this means that it results from irritation of the nerve roots). A percutaneous discectomy relieves pressure on the spinal cord and its associated nerves, which leads to significant pain relief.
What conditions can percutaneous discectomy help with?
The percutaneous discectomy procedure removes disc material to relieve pressure on nerves and the pain it causes.
It’s typically performed for degenerative disc disease. This 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.
This procedure may also provide pain relief for the following conditions:
- Herniated disc
- Spinal stenosis with herniation
Further, percutaneous discectomy could help with many other conditions that cause degeneration in the spine or the intervertebral discs.
An overview of the percutaneous discectomy procedure
Percutaneous discectomy is a minimally-invasive outpatient procedure that produces good results in the majority of patients who undergo it. The surgery itself takes about 30 minutes, and the whole office visit is less than two hours long.
Percutaneous discectomy uses a single-use probe called the Stryker Dekompressor, placed under X-ray guidance. Your doctor will use a local anesthetic at the point of injection. If you are nervous or concerned about pain, talk to your doctor. Your comfort is important, and they may offer you a mild sedative to take before you come to the office.
Before the treatment begins, you will be comfortably positioned on your stomach with your knees supported on the table. Once the treatment area is sufficiently numb, a larger needle is placed into the affected disc (also with X-ray guidance). Your doctor places the probe through this needle. The Dekompressor uses a pump method to remove excessive disc material from bulging or contained herniated discs, thus reducing pressure in your disc in order to relieve pain. You may feel pressure during this part of the procedure, but should not experience pain.
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. Rather than just treat symptoms, this treatment is designed to correct the underlying problem.
The procedure is minimally-invasive and causes much less scarring and fibrosis than is commonly associated with other interventions. In a 2018 study, 93% of patients reported positive outcomes from their lumbar percutaneous discectomy in terms of pain relief and mobility.
As with all medications and surgical procedures, there is always a risk of complications. 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 placement and sterile techniques.
Your site of injection may be sore or uncomfortable after the procedure, but that should ease in 48 hours or so. Hot or cold therapy may soothe discomfort, and your doctor may recommend pain medications, either over-the-counter or prescription for the first day or two afterwards.
Take it easy for a day or so after your percutaneous discectomy, gently easing into activity as feels comfortable. Most patients find they are back to their normal level of activity within a week.
Could percutaneous discectomy help me?
Patients who have herniated discs that have not responded to conservative treatment may benefit from percutaneous discectomy as an alternative to more invasive surgeries. Those suffering from other degenerative disc diseases or osteoporosis may also find relief with this procedure.
The reduction in pain allows patients to experience enough relief to become active again. Patients often regain the ability to resume their normal daily activities.
- 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