Percutaneous Disc Decompression (Nucleoplasty)

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Percutaneous disc decompression, also known as nucleoplasty, is a minimally invasive, fluoroscope image-guided discectomy procedure. This procedure treats leg, arm, chest, or buttocks pain caused by herniated discs.

During percutaneous disc decompression, a doctor uses image guidance to remove a small amount of disc tissue. This relieves pressure on the nerves to help reduce pain and restore mobility. The procedure typically takes one hour.

What is percutaneous disc decompression?

Percutaneous disc decompression is a minimally invasive surgical procedure. This procedure, also known as nucleoplasty, treats leg, arm, chest, or buttocks pain caused by a herniated disc.

A herniated disc is a spine injury. It is a tear in a disc’s outer layer, where the gel-like substance inside the disc bulges out. This can create pressure on a spinal nerve, leading to pain elsewhere in the body.

The percutaneous disc decompression procedure removes a small amount of disc tissue, relieving pressure on a targeted spinal nerve. This can help to reduce pain and restore mobility.

Medical Term Breakdown

  • “Percutaneous” means that the procedure passes through the skin.
  • “Disc” is short for an ‘intervertebral disc’, one of the spongy cushions that separate the bones of the spine (vertebrae). This term is also frequently spelled as “Disk”.
  • “Decompression” in surgery indicates a procedure to remove pressure on a structure, in this case, the disc structure.

Who is a good candidate for percutaneous disc decompression?

Candidates for percutaneous disc decompression have chronic pain due to disc herniation that is compressing a spinal nerve. This treatment is best for patients experiencing pain radiating to the arms, legs, chest, or buttocks.

This procedure is generally less effective for patients who only feel pain in the back or neck.

A doctor might recommend percutaneous disc decompression if:

  • After 6 to 12 weeks, conservative methods like physical therapy or steroid injections have not been successful in easing symptoms.
  • Nerve weakness is causing a patient difficulty when standing or walking.
  • Pain is radiating into the legs, arms, chest, or buttocks and has become too intense to handle.

How is the percutaneous disc decompression procedure done?

Percutaneous disc decompression is most often performed as a minimally invasive procedure.

During the procedure, a doctor makes a tiny puncture into the herniated disc’s outer lining, called the annulus. The doctor then uses very small instruments to remove some of the excess soft gelatinous material inside the disc. This disc material is the nucleus pulposus.

This process relieves the size of the disc’s bulge, reducing the painful pressure on the impacted spinal nerve. The procedure typically takes one hour in an outpatient surgery setting.

What are the risks or possible complications of percutaneous disc decompression?

All surgeries have risks, even minimally invasive surgeries. Potential complications include, but may not be limited to:

  • Infection
  • Bleeding
  • Nerve damage
  • Blood vessel damage
  • Worsening pain

There are several ways for a doctor to perform this procedure, each with its own potential risks and complications. Patients should review those risks with their doctor according to the specific procedure that they are considering.

What are the benefits of percutaneous disc decompression?

Patients benefit from pain relief, a reduced need for pain medication, and an improved ability to carry out normal daily activities.

Studies have shown low complication rates for this outpatient procedure versus spine surgery alternatives.

How long does it take to recover from percutaneous disc decompression?

Everyone is unique, so recovery times may vary. However, most patients go home within hours of the procedure, which is normally done in an outpatient setting.

When can I go back to work or school after percutaneous disc decompression?

Scheduling a return to work depends on the procedure used and the patient’s job and lifestyle. A doctor will consider factors such as a patient’s expected lifting, walking, and sitting activities.

After the procedure, a patient can generally return to work in 3 to 5 days, depending on their doctor’s guidance.

What precautions should I take after a percutaneous disc decompression procedure?

Percutaneous disc decompression can provide pain relief. However, this relief may not be long-lasting. This is because the procedure does not address the underlying cause of the herniated disc.

It is important to reach and maintain a healthy weight to reduce stress on the disc. Patients should limit themselves to low-impact exercises to help prevent re-injury. They should also limit repetitive bending, twisting, or lifting activities.

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