Minimally Invasive Discectomy

Percutaneous Discectomy (PD) is performed through a cannula inserted into the center of the vertebral disc under local anesthetic using a stylet. After the position of the stylet is confirmed to be correct using AP and Lateral X-ray fluoroscopy views, it is removed leaving the cannula in place. The disc material may be removed using surgical tools such as the Dekompressor or special microsurgical tools, however the manual instruments require a larger cannula and more disruption to the surrounding structures. Both the automated and manual percutaneous discectomy procedures produce similar results and reduction in disc height and pressure on the nerves to result in pain reduction.

Percutaneous Cervical Nucleoplasty

The patient is placed in the supine position with the neck extended, and the procedure is performed under intravenous sedation, the C-arm fluoroscopy is used in anteroposterior and lateral planes to direct the placement of the introducer needle onto the disc surface.

Percutaneous Lumbar Nucleoplasty

The patient is positioned in the prone position, using a posterolateral approach under fluoroscopy; a 17-gauge needle is inserted through the skin into the center of the nucleus. A slightly curved spine wand is then advanced through the needle until the distal end of the tip touches the inside wall of the anterior annulus.

Automated Percutaneous Discectomy

Techniques can be broadly divided into techniques that are designed to remove or ablate disc material and thus decompress the disc or those that are designed to alter the biomechanics of the disc annulus.

Percutaneous Endoscopic Discectomy (PED)

PED is a new technique for removing “contained disc herniation with the aid of specially developed instruments. The technique combines rigid straight, angled, and flexible forceps with automated high-power suction shaver and cutter systems.

Percutaneous RFA (Radiofrequency Annuloplasty)

The annuloplasty is a minimally invasive procedure for managing chronic discogenic back pain in patients who have failed conservative treatment, and who otherwise are possible candidates for spinal fusion.