Percutaneous Discectomy

Percutaneous Discectomy

Percutaneous Discectomy

0

What is Percutaneous Discectomy?  Just the words themselves seem intimidating.  But,  in the most basic form,  it means a large bore needle is placed into the disk,  and either a suction device, or a disc vaporization device is used to remove disk material from the end of the needle.  usually,  a very small incision,  or a small needle puncture is all that is visible after the surgery.  I am sure we have all seen the advertisements on the airplane magazines of a person strolling on the beach,  with a small bandage on their back.  That advertisement is usually used to promote the percutaneous disectomy procedure.

Percutaneous Disectomy has many pseudonyms.  It has also been called Laser Disectomy,  or Plasma Disk Decompression.  But,  the techniques always remain the same.  Usually,  the patient is sedated, but not completely asleep.  Using x-rays guidance,  a small gauged needle is placed carefully in to the disk, and confirmation of appropriate placement in two planes  (AP, and Lateral).  Because the patient is awake,  surgeons can avoid placing the needles too close to a nerve.  Once appropriate needle placement is confirmed.  The needle is used as a cannula to guide a small working channel to the disk.  As I explain to patients,  effectively a small straw is placed over the needle, and then inserted into the disk.  After the straw,  or working channel is confirmed as being in the disk,  instruments then can be passed into the disk to remove disk material that is thought to be causing the pain.

As far as instruments are concerned,  there are many different systems that can be utilized to remove the disk material.  Some systems have endoscopes,  or camera lens introduced into the channel,  allowing visualization of the removal of the disk material.  Some systems use lasers or radio frequency energy to evaporate the disk material.  Others use suction devices, as well as mechanical resection of the disk material.  Not matter which device is used,  the goal is always the same.  Removal of disk material that is thought to be the cause of pain.

Unfortunately,  the outcome of the procedure has not been as predictable as most surgeons would like.  That is because often times,  it is not certain that the offending disk material has been adequately removed.   While the center of the disk can be debulked,  it can be difficult to know if the nerve pressure has been relieved.  While certain systems do allow visualization with a camera,  the learning curve to that technique can be steep,  and few operators have been successful in reproducing visualization of disk removal on a constant basis.

While complications are rare,  they do occur.  The most common failure,  however, is inability to adequately relieve the nerve compression pain.

As a late by product of the procedure,  we now know that placing large bore needles in disks can cause more rapid degeneration of the disk,  and therefore contribute to a more rapid development of back pain for some patients.

As of today,  this procedure is offered by some spine surgeons.  But,  if you are interested in this procedure,  please discuss the pro’s and con’s with your surgeon.  Please have your surgeon discuss the expected outcomes,  and also discuss further treatment options if the surgery does not result in improvement of your pain.   And,  most importantly,  before you pursue any surgery,  make sure you have adequately exhausted all the non-surgical options before pursuing surgical care.

 

 

 

 

Citations

  • Rasouli MR, Rahimi-Movaghar V, Shokraneh F, Moradi-Lakeh M, Chou R. Minimally invasive discectomy versus microdiscectomy/open discectomy for symptomatic lumbar disc herniation. Cochrane Database Syst Rev. 2014 Sep 4;(9):CD010328. PubMed PMID: 25184502

No comments

Leave a Reply

Your email address will not be published. Required fields are marked *

*
*

Disclosure Statement

The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information:
verify here.

Author and Contributor to www.Spine-Health.com – July, 2015

www.Spine-Health.com/author/john-h-shim-md-facs

Chief of Surgery, Mease Countryside and Mease Dunedin Hospitals, Safety Harbor and Dunedin, Florida. 2014-2016.

Orthopaedic Section Chief Mease Countryside Hospital; Safety Harbor, Florida Mease Dunedin Hospital; Dunedin, Florida.2008-2013

Board Member Morton Plant Mease Research Council

Co-Director of Mease Neuro-Ortho Spine Center Mease Dunedin Hospital; Dunedin, Florida.

One of “6 Spine Physicians Ranked #1 on Google” – December 2016

Top Ten Most Liked Spine Surgeons on the Internet – July 2016

2016 Spine Surgeons to Know list – January 2016

2014 Spine Specialists to know list – September 2014

One of Ten Leaders of Certified Spine Programs – December 2011

 

The Best Orthopedics in Tampa

The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.
Outpatient Spine Surgery Considerations. www.Spine-Health.com. January 2016.

What is Spinal Stenosis? www.Spine-Health.com. October 2015.

Surgeon insights on the Changing Landscape of Orthopedic Care. OrthopedicToday. June 2014

Chapter 33: Interspinous Spacers. Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

Chapter 35: Minimally Invasive Percutaneous Lumbar Fusion Technique.Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

March 2010 Minimally Invasive Transforaminal Lumbar Interbody Fusion American Academy of Orthopaedic Surgeons Annual Meeting New Orleans, Louisiana February 2010

February 2010 A Review of Dynamic Stabilization in the Lumbar Spine Selby Spine Symposium; Park City, Utah

November 2009 Lumbar Spinal Stenosis Community Based Lecture; Tampa, Florida

September 2009 Instructor/Proctor Minimally Invasive Lumbar Cadaver Lab; Tampa, Florida

February 2009 New Spinal Technology: Cervical Disc Replacement and Interspinous Spacers. Selby Spine Symposium; Park City, Utah

February 2008 The Degenerative Spine: The Role of Dynamic Lumbar Stablization and Interspinous Spacers Selby Spine Symposium; Park City, Utah

October 2008 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

September 2007 Emerging Technology in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

October 2006 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

May 2005 The Role of Kyphoplasty in the Treatment of Vertebral Compression Fractures Mease Neurosciences Symposium; Clearwater, Florida
Please note all articles, blogs and Q&A’s on this site are general information and are not to be used as medical advice for individuals. No specific diagnosis or treatment should be made based on this information. Only a physician can provide you with advice specific to your situation. Please followup with your physician if you would like to discuss your individual condition.

If you are having a medical emergency,  contact your Doctor immediately,  or go to the Emergency Room.
ShimSpine and ShimSpine.com is committed to honoring and respecting the privacy and anonymity of the individuals using its website(s) and/or services. The purpose of this Privacy Policy is to inform the individuals about the collection, processing and protection of information done by ShimSpine what information we collect, why we collect this information and how we use this information.

This Privacy Policy will be reviewed regularly to reflect the up-to-date practices of ShimSpine.