What is Percutaneous Disc Decompression?
Percutaneous Disc Decompression procedure is indicated in patients who are suffering from pain, numbness or disability resulting from a bulging or herniated lumbar disk. Most often, these patients are presenting with pain in the lower back, which may be radiating into either leg and foot, or both, and is often associated with numbness. It is indicated in certain patients with low back pain only, after further diagnostic testing. Similarly, it may be appropriate in patients with leg pain only, resulting from an abnormal lumbar disk.
The appropriate diagnostic evaluation prior to this procedure will nearly always involve a cervical or lumbosacral spine MRI as well as complete history and physical examination. If the pain is limited to the lower back without obvious radiation into the legs, discography or injection of contrast dye into the disk to further elucidate the pain mechanism may be required. The extent of disk bulge or herniation must be modest, as large herniated disks may not respond well to this treatment. On the other hand, it should be noted that patients with small bulging or herniated disks may benefit more from this non-invasive treatment than from a surgical approach to treating their disk abnormality.
Nucleoplasty uses a coblation technology, which utilizes radiofrequency energy to ablate tissue inside the disk resulting in decompression of the disk and thermal alteration of the tissue. This effectively reduces the extent of disk protrusion, as well as desensitizing the disk itself. The resultant pain relief should be obvious within several days after the procedure and the pain associated with the procedure itself is quite minimal.
The procedure is done through a needle that is placed into the herniated disc after numbing the skin. Real time X-ray guidance is used to properly locate the needle tip inside the abnormal disk and contrast dye may be injected to confirm optimal placement. A wand is placed through the needle, to generate radio waves that dissolve excess disk tissue, reducing the size of the disk. This relieves the pressure in the disk and on adjacent nerves.
This procedure is done on an outpatient basis with minimal recovery necessary and with very low incidence of complications. The result is disk decompression and pain relief, accomplished without surgical intervention and with far less opportunity for complication or need for rehabilitation.
DeKompressor technology reduces the herniated disc by removing tissue using a rotary action through a needle. This achieves similar results to Nucleoplasty, effectively creating a space or vacuum effect within the disc, pulling the herniation or bulge backward.
Hydrocision uses a probe placed through a needle which generates a high pressure water stream; effectively eating the internal disc material which is then removed through a separate port in the probe. The herniated disc is then decompressed.