Disc decompression, also known as Percutaneous Discectomy, is a minimally invasive outpatient procedure that is used by physicians to treat a painful intervertebral disc in the spine. Performed by interventional pain physicians or spine surgeons, this procedure is much less invasive, has a much more rapid recovery, and can be an equally effective treatment alternative compared to an open surgical procedure like open laminectomy and discectomy.
Who is a candidate for Disc Decompression?
A disc decompression is performed on patients who are experiencing “radicular” pain, which is defined as pain that radiates along the distribution of a spinal nerve root. An example would be a patient with a herniated disc in the lumbar spine who has low back pain that radiates down the leg to the foot. This procedure is most commonly performed on painful discs in the lumbar spine (lower back), although it is being offered for cervical (neck) and thoracic (mid back) discs as well. Patients have generally failed to improve with conservative treatments, including medication, physical therapy, and spinal injections like Epidural Steroid Injection. Patients with a relatively small or contained disc herniation are better candidates than those with large herniations. The presence of a free disc fragment or significant disc space narrowing on MRI is a contraindication to Disc Decompression. Furthermore, a patient’s candidacy for Disc Decompression is often determined by a Discogram to confirm that the target disc(s) is/are indeed the cause of a patient’s pain. The discogram is especially important if a patient’s MRI reveals more than one abnormal disc in the painful area of the spine, since a patient’s pain can originate from two or more discs.
How is this procedure done?
Disc Decompression is a relatively brief 30-45 minute outpatient, X-Ray guided procedure that is performed under local anesthesia, occasionally supplemented with the administration of intravenous sedation to relax the patient. General anesthesia is NOT required for Disc Decompression, and therefore the recovery from this procedure is quite rapid. Sterile technique is utilized to minimize the risk of infection.
- A patient is positioned prone for the Disc Decompression procedure.
- A cannula or needle is placed into the painful disc and Nucleus Pulposus material is removed.
- Disc decompression relieves the pressure on the exiting nerve root located behind the disc.
- The Dekompressor Probe removes material from the center of a painful intervertebral disc.
- Disc material is removed from the tip of the Dekompressor probe.
Does this procedure hurt?
Disc Decompression is a well-tolerated procedure offered to adult patients of all ages. Because it is minimally invasive, Disc Decompression can be performed under local anesthesia in an outpatient surgery center. Some patients experience an increase in back pain for a few days but most patients are back to work quickly.
What should I do to prepare for my procedure?
You should not eat or drink anything at all after midnight the night before your scheduled procedure. You must have a responsible adult available to drive you home. If possible, you should shower and use an antibacterial soap like Lever 2000 before your procedure. If you usually take a morning dose of medication for asthma, stomach ulcers or acid reflux, high blood pressure or any kind of heart condition, it is very important that you take this medication at the usual time with a small sip of water before your procedure.
If you are taking any type of medication that can thin the blood and cause excessive bleeding, you should inform your physician and discuss with your other doctors (PCP, Cardiologist) whether to discontinue this medication prior to the procedure. Examples of medications that could promote surgical bleeding include Coumadin, Plavix, Aggrenox, Pletal, Ticlid, and Lovenox. Anticoagulant meds are usually prescribed to protect a patient against stroke, heart attack, or other vascular occlusion event. Therefore, the decision to discontinue one of these medications is not made by the pain management physician but by the primary care or specialty physician (cardiologist) who prescribes and manages that medication.
A back brace is usually recommended for patients recovering from this procedure. Patients are responsible for purchasing the brace from a medical supply store or pharmacy. The brace should be worn during awake hours every day after the procedure until the treating physician provides clearance to discontinue its use.
How rapid is the recovery after Disc Decompression?
The immediate recovery from this procedure is quite rapid. Since Disc Decompression can be performed without general anesthesia, patients generally get up and walk out of the surgery center within an hour of completion of the procedure. Most patients will return to work within 7- 10 days following Disc Decompression. Occasionally physical therapy is required after disc decompression to help strengthen a patient’s weakened back and/or leg muscles and to teach a patient how to avoid recurrence of the condition that precipitated the need for this procedure.
Could there be side effects or complications?
Modern medicine has improved the safety in every aspect of patient care. However, there is no guarantee of a perfect outcome with any test or procedure. Fortunately the side effects and complication profile for Disc Decompression is very low. The doctor will discuss this issue with you before the procedure.
What are the chances that Disc Decompression will work to relieve my pain?
This procedure has been performed with variations in technique for decades. Most studies confirm that Disc Decompression is safe and very effective in treating disc-related back and leg pain for well-selected patients.