FAQs on Percutaneous Discectomy (MILD) in Colorado
A percutaneous discectomy involves the removal of central disc material without removing the actual disc itself. The procedure involves insertion of a type of decompressor device that allows the disc material to be suctioned away. Also called the minimally invasive lumbar discectomy (MILD), the percutaneous discectomy is recommended for people who have not responded to usual treatments.
Who is a candidate for the percutaneous discectomy?
When you see the pain management professional, he will review your MRI scan to assess your disc problem. The percutaneous discectomy is used to prevent major spine surgery. You may be a candidate if:
- You are diagnosed with a disc bulge, but the disc has not ruptured.
- The pain is severe enough to keep you from walking and doing usual activities.
- The pain has not improved after four or more weeks of non-invasive conventional treatment measures.
- You have spinal stenosis.
- There is no disc material in the spinal canal.
- If nerve damage that affects your legs will continue to progress without intervention.
How do I prepare for the percutaneous discectomy?
Before the surgery, you meet with the physician to discuss your goals, your current condition, and your medical history. If the doctor decides the percutaneous discectomy would work for you, he may schedule additional imaging tests. Once you agree to the procedure, the doctor discusses the risks and benefits and has you sign a consent form. Because a sedative is given, you should not eat/drink 8 hours before surgery time, and must arrange to have a ride home.
How is the MILD percutaneous discectomy done?
After the nurse starts an IV line in your arm, you are connected to monitoring devices to assess heart rate, oxygen level, and blood pressure. A mild sedative is given after you are positioned face-down on the procedure table. The doctor cleans the skin over the targeted disc with an antiseptic, and uses a tiny needle and syringe to numb the skin with an anesthetic. A small incision is made, and the doctor inserts the decompressor needle into the disc. To assure correct needle placement, x-ray technology guides the doctor’s vision. Using gentle suction, the disc material causing the bulge or displacement is removed. The doctor may use a laser to destroy portions of the herniated disc to remove it easier.
What can I expect after the percutaneous discectomy procedure?
The procedure is done in an outpatient facility, so you go home the same day. Expect 20 minutes for preparation, 30 minutes for the procedure, and 2 hours for the recovery. A nurse monitors you while you wake up from sedation. You will have some post-operative pain, but the nurse will give you medication. Once you go home, we recommend resting for a couple days, and avoid lifting, excessive bending, and twisting.
Does the percutaneous discectomy work?
According to clinical studies, the percutaneous discectomy has a 70-80% success rate. Most patients can return to normal activities within a week, report decreased or no pain, and are happy with the procedure. In a study that spanned 14 years, and involved over 1,350 patients, researchers found that 58% of people are satisfied with the procedure at two months, and 68% are pleased at six months. People with discogenic pain, the elderly, and those who had previous back surgery tend to have higher satisfaction rates with this procedure.
Hu SS, et al. (2006). Disorders, diseases, and injuries of the spine. In HB Skinner, ed., Current Diagnosis and Treatment in Orthopedics, 4th ed., pp. 221–297. New York: McGraw-Hill.
Kim, H., Ju, C., Kim, S., & Kim, J. (2009). Huge Psoas Muscle Hematoma due to Lumbar Segmental Vessel Injury Following Percutaneous Endoscopic Lumbar Discectomy. Journal Of Korean Neurosurgical Society, (3), 192.