Cervical Percutaneous Discectomy
Cervical percutaneous discectomy is a procedure that is performed to remove herniated or bulging disc material that is pressing on nerves or the spinal cord. The cervical spine is the portion of the spine that runs through the neck. When the nerves of the cervical spine are compressed, it causes pain and discomfort in the neck that may travel to the shoulder, arm and hand. The goal of a cervical percutaneous discectomy is to decompress the nerves by removing deviated-disc material and disc fragments. It is a minimally invasive procedure that involves making a very small incision and inserting a tiny surgical needle between the vertebrae, into the middle of the disc. Disc material is removed with the guidance of live X-ray imaging, and as a result, painful nerve pressure is relieved.
The cervical spine is made up of seven vertebrae stacked on top of one other, each separated by a cushion known as an intervertebral disc. Each disc is composed of an exterior shell of tough cartilage, and a center of softer, more gelatinous material. Through aging, normal wear-and-tear or injury, a disc may bulge between the vertebrae. If a disc herniates (ruptures), it can put pressure on adjacent nerves, causing pain, tingling, numbness and other troubling symptoms. Cervical percutaneous discectomy may be performed to alleviate pain and relieve symptoms in patients with cervical spine disorders such as spondylolisthesis, stenosis and degenerative-disc disease.
Candidates for Cervical Percutaneous Discectomy
A cervical percutaneous discectomy may be a treatment option for patients with ongoing neck or upper-back pain, or pain that radiates down the arm. This procedure may be an option when more conservative treatment methods such as medication, corticosteroids, physical therapy or chiropractic treatment have failed to resolve symptoms after a period of about 6 weeks. A cervical percutaneous discectomy may also be considered if the patient has experienced chronic and severe pain, and symptoms have interfered with performing regular activities.
Benefits of Cervical Percutaneous Discectomy
There are many benefits to a cervical percutaneous discectomy. Because it is less- invasive than other types of surgery, there is minimal scarring from the incision, and the ligaments and surrounding discs remain intact. Additional benefits include:
- Commonly performed as an outpatient procedure
- Minimal blood loss
- Retained spinal mobility
Carrying less risk than other types of spinal surgery, a cervical percutaneous discectomy also allows for a more rapid recovery.
The Cervical Percutaneous Discectomy Procedure
A cervical percutaneous discectomy is commonly performed through the front (anterior) of the neck. This is referred to as an anterior cervical discectomy. However, if the herniated discs are affecting the back (posterior) of the spine, the procedure may be performed through the back of the neck in a procedure known as a posterior cervical discectomy.
Prior to the procedure, patients are sedated with general anesthesia. A small incision is made, and the skin and soft tissues are separated to expose the bones along the back of the spine. X-ray images are used to guide the movement of the needle and surgical instruments. The disc tissue is then extracted through the needle. When tissue is removed from the herniated discs, pressure on the nerves in the area, and the pain caused by that pressure, are both relieved. The cervical percutaneous discectomy takes about 30 to 45 minutes to perform.
Risks of a Cervical Percutaneous Discectomy
A cervical percutaneous discectomy is considered a minimally invasive and safe procedure. However, as with all types of surgery, there may be risks which, although rare, include:
- Reaction to anesthesia
- Nerve damage
- Excessive bleeding
- Infection
- Failure to remove all targeted disc tissue
If all of the disc tissue is not removed, pressure on the nerve and related symptoms may persist.
Recovery from a Lumbar Percutaneous Discectomy
Patients can usually return home the day of the procedure. Pain medication may be prescribed to control pain during the recovery period. After a cervical percutaneous discectomy, patients should avoid strenuous physical activity and any heavy lifting for several weeks. Physical therapy may be necessary to help the patient regain strength. Most patients can return to work after a week or two; however, those with more more physically demanding occupations may need to wait longer. Most patients experience positive results from a cervical percutaneous discectomy and have significant pain relief, which allows them to resume their normal activities free of pain.