Intradiscal Percutaneous Procedures
Disc nucleoplasty, officially called percutaneous disc nucleoplasty, sends pulses of radio waves into the nucleus of a herniated disc. These radio waves vaporize small amounts of disc material, creating an empty space within the disc. The material that has bulged out of the disc wall will then move to fill in this empty space, restoring the disc wall to its original shape. With the disc wall no longer herniated, the pressure on nerve roots or the spinal cord will disappear, providing immediate pain relief.
Recovery from this outpatient procedure is usually very quick because, like most minimally invasive surgery, it does not require the cutting of muscles or bone. With limited bed rest and a program of physical therapy, patients should resume normal activity within one to six weeks.
IDET stands for intradiscal electrothermal therapy. IDET is a minimally invasive procedure used to relieve chronic or severe low-back pain caused by diseased, damaged, herniated or degenerated discs. Performed on an outpatient basis, IDET involves the application of an electrothermal catheter, a thin heating wire, which delivers precise amounts of heat to a disc. This allows the physician to shrink or seal any tears or cracks in the outer wall of the disc, reduce the bulge of inner disc material known as a herniated disc, and cauterize (burn) and thereby disable painful nerve endings affected by the deformed disc.
Disc degeneration, a common effect of aging, may cause cracks in the wall of an intervertebral disc and/or herniated discs, in which the inner tissue of a disc bulges out through these cracks in the outer wall. This degeneration may cause crippling lower-back pain. IDET uses heat to repair some of the effects of degeneration and thereby significantly reduce the patient’s pain. During the procedure, the heating of the catheter may cause some discomfort, an indication that your physician has located the correct source of the pain. In 80% of the patients who undergo IDET, the procedure relieves or eliminates chronic lower-back pain and provides greater functional mobility.
A discectomy removes part of a herniated disc because it is irritating a nerve and causing pain. In this minimally invasive procedure, a small needle is advanced to the herniated disc guided by a fluroscope. A probe with a rotating tip is then inserted through the needle to reach the herniated disc. When the probe is turned on, its tip drills away part of the disc nucleus, creating space for the herniated disc wall and relieving pressure on the nerve.
One of the most commonly performed procedures in the country, the dekompressor discectomy is used to preserve or restore neurological function, stabilize spinal segments, improve functional status, and relieve pain. Generally, the operation is performed on patients who have had back and leg pain for at least six weeks, usually as of a result of undue pressure exerted on a nerve.
Depending on the location and the severity of the disc damage, the operation will be performed using open surgery, which usually requires an incision 1-1/2 inches long.