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.
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.
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.
