Percutaneous discectomy refers to a surgical procedure where the central portion of the intervertebral disc is removed using a cannula. The cannula is inserted in the back of the vertebral disc under a local anesthetic and using a stylet. The position of the stylet is confirmed through the use of AP and x-ray lateral views and when the confirmation is made that the targeted area has been reached, the stylet is removed and this leaves the cannula in place.
While the x-ray is used in the guidance of the movements involved in the procedure, there are other small tools that are inserted in the herniated disc. Some of the tools that might be involved in this process include traditional surgical tools or Dekompressor but the manual instruments will need larger cannulas and more disruptions to the structures surrounding the disc. Both the manual and the automated procedure will have similar results and lead to a reduction of pain experienced by the patient. The disc tissue is removed through sucking it out, cutting it out or through lasers which evaporate or burn the disc. The disc material that is herniated will not be directly removed using this procedure.
Percutaneous discectomy is recommended for patients with low back pain and leg pain caused by disc herniation and conservative treatment have shown no progress in relieving pain and are interested in minimally invasive surgical procedures prior to any attempt of conventional surgery. This procedure can be performed under the guidance of fluoroscopy or in a similar manner as microsiscetomy. This will reduce the opening to a small needle prick as compared to the standard open discetomy which involves an incision which may be 1 inch or greater.
The benefit of percutaneous discectomy is that 95% of the patients will experience immediate pain relief. The access to the herniated disc is direct and the ligament and disc annulus remain intact throughout the procedure. There is no need for a general anesthesia, only a local anesthetic is needed to numb the site. The procedure can be carried out on an outpatient basis and the patient will need a shorter rehabilitation period as compared to other methods used in the treatment of the condition. The procedure will result in a small incision which will require one stitch at most meaning that there will hardly be any scarring and the patient can return to their normal activities in a short period of time.
A patient can leave the recovery room about 2 hours after the operation and be in good shape. Most will be in an outpatient basis but others can leave the hospital in a day which is mostly because of the checkups done by the physiotherapy and the surgeon who operated on them. Light or easy office task can be handled by the patent in a period of one week after the operation and heavier task will be allowed after only 6 weeks. This procedure is a difficult one compared to other treatment methods but has proved to be successful and safe in the treatment of herniated discs and the complication rate is at minimal levels.