Percutaneous Lumbar Discectomy
Discogenic leg pain is a primary cause of healthcare expenditure. The two entities of back pain and discogenic leg pain produce more days lost than any other combined illness and injuries, costing the US healthcare system over $20 billion per year.1,2
Pain from discogenic sources typically is produced from annular breakdown and annular tears.3,4 This is commonly treated with a microdiscectomy by orthopedic surgeons and neurosurgeons. Open discectomy has been the “gold standard” for relieving pressure on nerve roots. By decompressing the nerve root from the disc itself, neurologic function is usually restored, and pain is relieved. Because of the annular violation that happens from the surgical procedure, recurrent disc herniations may occur and typically do.5 Because of that, a number of percutaneous procedures have been developed over the last several decades specifically focused on this disc pathology. This includes chemonucleolysis, automated/manual percutaneous nucleotomy, laser treatments, intradiscal thermal annuloplasty, and, more recently, nucleoplasty and dekompressor. All of these are designed to reduce intradiscal pressure and can allow the protruded disc area to retract back into place as long as there is enough elastogenicity to allow recovery.
KeywordsNerve Root Intradiscal Pressure Outer Annulus Discogenic Pain Posterior Annulus
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