Percutaneous Discectomy
The entire decompression can be performed percutaneously (per – through; cutaneous
- skin i.e. through a small hole in the skin) using a needle. Patients who may
benefit from percutaneous disc decompression or 'percutaneous
discectomy' as it is called, are those with pain arising from a bulging disc
WITHOUT HERNIATION of the nucleus pulposus – i.e. a bulging disc
where there is NO RUPTURE of the annulus fibrosus.
The entire procedure takes about 30 minutes and the patient is able to leave the
recovery area with only a small bandage over the needle insertion site. When completed,
the small hole will fill in on its own. There is little tissue damage and recovery times may
be improved in many patients. Although long-term data is not available, early
studies show sustained pain relief for a year or more. TO REPEAT: This
procedure is useful ONLY IN SELECTED ISOLATED CASES of bulging disc
compression with no other pathological features of arthritis, stenosis due
to spur formation or spondylolisthesis.
Chemonucleolysis
Injection of chymopapain or other enzymes to dissolve the inner disc may relieve
pressure on the nerves by shrinking the bulging or herniated disc. Not all orthopods
do or are in favor of this procedure as the results may vary for different
individuals.
Surgery for OsteoarthritisOnly a few people with low back pain due to osteoarthritis need surgery. Although
osteoarthritis tends to be chronic, the symptoms are rarely progressive and rarely
require surgery on the painful spinal joints. Surgery may be needed for certain patients
with severe cases of spinal arthritis that leads to instability of the joint (degenerative
spondylolisthesis) or nerve root pinching (spinal stenosis). Both conditions can
eventually cause stenosis of the spinal canal.