Percutaneous Discectomy for a Lumbar Herniated Disc
Surgery Overview
Percutaneous means "through the skin" or
using a very small cut. Discectomy is surgery to remove herniated
disc material that is pressing on a
nerve root or on the spinal cord.
There are many different kinds of percutaneous discectomy procedures. All of them use small instruments that are inserted between the vertebrae and into the middle of the
disc. Most of the time they are done in a surgery center using local or general anesthesia.
X-rays help guide the movement of the
instruments during surgery. The surgeon can remove disc tissue by either:
- Cutting it out.
- Sucking out the center of the disc.
- Using lasers to burn or destroy the disc.
What To Expect After Surgery
You can expect to go home on the same
day you have the procedure.
You can use prescription medicine to control pain
while you recover.
For several weeks after surgery, you'll need to avoid long periods
of sitting and avoid bending, twisting, and lifting.
Why It Is Done
Lumbar (low back) percutaneous discectomy may be done
if:
- Your medical history, physical exam, and diagnostic tests
(such as MRI, CT scan, or myelogram) show that the disc is bulging, and the
material inside the disc hasn't ruptured into the spinal
canal.
- Pain and nerve damage have not improved after 4 or more
weeks of nonsurgical treatment.
- Your symptoms are very bad and get in the way of doing normal activities.
- There are signs of serious nerve damage in your leg that may be
getting worse. These signs include severe weakness, loss of coordination, or
loss of feeling.
Lumbar Herniated Disc: Should I Have Surgery?
It should not be done if you have:
- Pieces of disc material in the
spinal canal (as seen on a CT scan or MRI).
- Narrowing of the spinal
canal (spinal stenosis).
How Well It Works
Although surgery for a lumbar herniated disc doesn't work for everyone, it works well for many people. Regular discectomy works a little better than percutaneous discectomy.1
Risks
During a percutaneous discectomy, the surgeon
has no way of seeing the herniated disc or the pinched nerve.
The surgery might not remove the disc tissue. So there is no guarantee
that pressure on the nerve will improve.
There are risks with anesthesia.
What To Think About
More research needs to be done to compare this surgery to other types of discectomy and to nonsurgical treatment.
Complete the surgery information form (PDF) (What is a PDF document?) to help you prepare for this surgery.
References
Citations
- Hu SS, et al. (2006). Lumbar disc herniation section
of Disorders, diseases, and injuries of the spine. In HB Skinner, ed.,
Current Diagnosis and Treatment in Orthopedics, 4th ed.,
pp. 246–249. New York: McGraw-Hill.
Credits
| By | Healthwise Staff |
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| Primary Medical Reviewer | William H. Blahd, Jr., MD, FACEP - Emergency Medicine |
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| Specialist Medical Reviewer | Robert B. Keller, MD - Orthopedics |
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| Last Revised | March 12, 2012 |
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Last Revised:
March 12, 2012
Hu SS, et al. (2006). Lumbar disc herniation section
of Disorders, diseases, and injuries of the spine. In HB Skinner, ed.,
Current Diagnosis and Treatment in Orthopedics, 4th ed.,
pp. 246–249. New York: McGraw-Hill.
