Percutaneous Discectomy for Herniated Discs Using a Discectome
In modern surgery—including spinal surgery—there is a growing trend toward performing minimally invasive procedures whenever possible. Vertebrologists from the Galaxia Center in Moldova aim to prioritize advanced technologies that significantly outperform traditional methods in terms of effectiveness, while also being considerably safer.
For intervertebral disc herniations, percutaneous (i.e., through the skin) discectomy is now being successfully practiced. This technique differs from open, conventional discectomy in that it does not require a large surgical incision: all manipulations are carried out through a miniature access point, under the guidance of advanced imaging equipment.
Through a small incision, a fragment of the intervertebral disc is removed to decompress the nerve root or spinal cord, thereby relieving pain and neurological symptoms. The entire process of percutaneous discectomy is performed under angiographic control. The procedure typically lasts 30–45 minutes, and upon completion, the skin puncture site is covered with a sterile medical dressing. Within the next two hours, the patient remains under observation in the recovery room and can then leave the clinic with post-operative recommendations.
Over the following two to three weeks, patients are advised to follow a protective regimen: wearing a custom-fitted plastic orthopedic brace that reduces spinal load and allows for normal daily activities (excluding physical strain).
For several weeks, patients should avoid physical exertion, excessive spinal movements (bending and extending), and heavy lifting. To manage any post-operative pain, if needed, the doctor may prescribe analgesics. About six weeks after surgery—when patients can generally resume normal activities and even sports—doctors recommend beginning a back muscle strengthening exercise program.
Thanks to the fact that this method preserves most of the intervertebral disc tissue and minimizes post-operative complications, it is especially recommended for elderly patients and individuals with comorbid conditions, such as diabetes mellitus.
Advantages of Percutaneous Discectomy
- It is much better tolerated by patients due to its minimally invasive nature.
- The use of local anesthesia offers additional benefits—avoiding general anesthesia-related risks and allowing same-day discharge.
- There is no compression of nerve fibers, no epidural bleeding, no need for metallic implants (artificial discs) or spinal fusion, and disc height is preserved.
- There is no spinal instability, and recurrence of the condition within the nucleus pulposus can be prevented, as the operation creates a compact channel in front of the disc.
- And finally, there is an excellent cosmetic result: after this minimally invasive procedure, no visible scars remain.
Before performing a percutaneous discectomy, a comprehensive diagnostic workup is carried out, including CT and MRI scans.
WHEN IS PERCUTANEOUS DISCECTOMY INDICATED?
Indications for percutaneous discectomy include:
- When diagnostic imaging reveals an intervertebral disc herniation where the nucleus pulposus remains within the center of the disc and does not extend into the spinal canal.
- In cases of persistent symptoms, where the pain syndrome does not subside after four weeks of conservative treatment.
- In the presence of significant neurological symptoms, such as muscle weakness in the leg, loss of coordination, numbness, or paresthesia.
- In cases of severe pain that disrupts the patient’s physical activity.
Contraindications for percutaneous discectomy:
Spinal canal stenosis (narrowing of the spinal canal).
The presence of disc fragments (either the annulus fibrosus or nucleus pulposus) within the spinal canal, as detected on CT or MRI.
