Unlike endoscopic decompression, for some patients, an even more minimally invasive methods have been made available, whereby the entire decompression is performed percutaneously through a needle placed through the skin rather than through small incisions.
Patients who may benefit from percutaneous disc decompression or ‘percutaneous discectomy’ as it is also called, are those with pain arising from a contained herniated disc – that is a bulging disc where there is no rupture in the outer wall. Patients requiring decompression surgery are typically those suffering sciatica or leg pain caused by a herniated or slipped disc.
Early procedures showed conclusively that percutaneous disc decompression effectively relieves pain for appropriate patients.
An advanced form of percutaneous discectomy developed to date uses a plasma technology to remove tissue from the center of the disc. During the procedure, an instrument is introduced through a needle and placed into the center of the disc where a series of channels are created to remove tissue from the nucleus. Tissue removal from the nucleus acts to decompress the disc and relieve the pressure exerted by the disc on the nearby nerve root. As pressure is relieved, pain is reduced. There is little tissue trauma and recovery times may be improved in many patients.
Evidence is mounting that pain relief is sustained through two years post-procedure and beyond.
Who is the right patient?
For appropriately selected patients, percutaneous discectomy can help relieve back and leg pain symptoms, including sciatica and radiculopathy and even pure axial pain caused by a ‘central focal protrusion’ or central bulge of the disc. Percutaneous discectomy is a widely accepted treatment for patients with small contained herniations for whom open surgical discectomy offers a better outcome. It may also be a promising option for patients with large contained (non-ruptured disc) herniations for whom open surgery is not considered an appropriate treatment due to underlying medical conditions or other reasons.