| r |
Disc disease is one of the most common causes of chronic neck and back pain and accounts for approximately 10% of all
lower back pain complaints. Disc disease may be acute, herniation resulting from trauma, or more commonly from chronic
disease. Degenerative disc disease is a process, which is due to a thinning and degeneration of the discs over time.
Commonly seen, neck and back pain may go into painless remission with periods of decreased or absent symptoms,
however, the pain often returns causing a chronic pain syndrome. If your pain has lasted longer than four weeks or is
severe in nature you should see a pain specialist about treatment options. Ongoing research has hinted that early
intervention decreases the incidence of developing chronic pain. Decompression therapy is often considered when the
pain has not improved after a month and is radicular, resulting from irritation of the nerve roots.
Procedure
Percutaneous Discectomy uses a single-use probe called the “Stryker Dekompressor” which is placed under x-ray
guidance. You will be pre-treated with a sedative that will help you to relax, but you will remain awake for the procedure.
Before the treatment begins, you will be comfortably positioned on your stomach, with your knees supported on the table.
Your physician will inject a local anesthetic with a small needle to numb the area. Once the area is numb, a larger needle
is placed into the affected disc with x-ray guidance. The probe is placed through this needle and the procedure is
initiated. You may feel pressure during this part of the procedure, but should not experience pain.
The Dekompressor uses a pump method to remove excessive disc material from bulging or contained herniated discs,
thus reducing pressure in the disc and providing pain relief.
Benefits
A discectomy using the Dekompressor is a lower-risk treatment option for neck and back pain. The procedure may
decrease pain, increase mobility, and eliminate the need for traditional surgical interventions. This treatment is designed
to correct the underlying problem, not just relieve the symptoms. The procedure is a minimally invasive procedure that
causes much less scarring and fibrosis that is commonly associated with other interventions. A study reported in 2007
“discectomy is minimally invasive, safe and effective for treating disc herniations and that 89% of patients treated by this
method stated they achieved successful outcomes from the therapy“ (Tzaan 2007).
Risks
As with all medications and surgical procedures, there is always a risk of complications. With lower risks than traditional
back surgery, discectomy is considered an appropriate treatment for many patients who suffer from back pain (Boswell
2007). The most common complaint is mild back pain at the injection site shortly after the procedure. Other more serious
and far less common complications include spinal cord compression, excessive intracranial pressure, bleeding,
hematoma, or infection. These particular risks are decreased by the use of x-ray and sterile technique.
Outcome
The American Society of Interventional Pain Physicians developed a large evidence-based practice guideline for the
management of chronic spinal pain with interventional techniques. The 2007 article stated that for percutaneous
discectomy using the Dekompressor resulted in greater than 70% improvement in pain in 79% of patients undergoing the
treatment for postero-lateral disc herniations. (Boswell 2007). The reduction in pain allows patients to experience
enough relief to become active again. Often patients regain the ability to resume their normal daily activities.
If you are suffering from chronic back or neck pain contact Arizona Pain Specialists today to see if you can benefit from
this advanced treatment.
Journal Articles
Interventional techniques: evidence-based practice guidelines in the management of chronic spinal pain. Boswell MV,
Trescot AM, Datta S, Schultz DM, Hansen HC, Abdi S, Sehgal N, Shah RV, Singh V, Benyamin RM, Patel VB,
Buenaventura RM, Colson JD, Cordner HJ, Epter RS, Jasper JF, Dunbar EE, Atluri SL, Bowman RC, Deer TR, Swicegood
JR, Staats PS, Smith HS, Burton AW, Kloth DS, Giordano J, Manchikanti L; American Society of Interventional Pain
Physicians. Pain Physician. 2007 Jan;10(1):7-111 PMID: 17256025
Transforaminal percutaneous endoscopic lumbar discectomy. Tzaan WC. Chang Gung Med J. 2007 May-Jun;30(3):226-
34 PMID: 17760273
lower back pain complaints. Disc disease may be acute, herniation resulting from trauma, or more commonly from chronic
disease. Degenerative disc disease is a process, which is due to a thinning and degeneration of the discs over time.
Commonly seen, neck and back pain may go into painless remission with periods of decreased or absent symptoms,
however, the pain often returns causing a chronic pain syndrome. If your pain has lasted longer than four weeks or is
severe in nature you should see a pain specialist about treatment options. Ongoing research has hinted that early
intervention decreases the incidence of developing chronic pain. Decompression therapy is often considered when the
pain has not improved after a month and is radicular, resulting from irritation of the nerve roots.
Procedure
Percutaneous Discectomy uses a single-use probe called the “Stryker Dekompressor” which is placed under x-ray
guidance. You will be pre-treated with a sedative that will help you to relax, but you will remain awake for the procedure.
Before the treatment begins, you will be comfortably positioned on your stomach, with your knees supported on the table.
Your physician will inject a local anesthetic with a small needle to numb the area. Once the area is numb, a larger needle
is placed into the affected disc with x-ray guidance. The probe is placed through this needle and the procedure is
initiated. You may feel pressure during this part of the procedure, but should not experience pain.
The Dekompressor uses a pump method to remove excessive disc material from bulging or contained herniated discs,
thus reducing pressure in the disc and providing pain relief.
Benefits
A discectomy using the Dekompressor is a lower-risk treatment option for neck and back pain. The procedure may
decrease pain, increase mobility, and eliminate the need for traditional surgical interventions. This treatment is designed
to correct the underlying problem, not just relieve the symptoms. The procedure is a minimally invasive procedure that
causes much less scarring and fibrosis that is commonly associated with other interventions. A study reported in 2007
“discectomy is minimally invasive, safe and effective for treating disc herniations and that 89% of patients treated by this
method stated they achieved successful outcomes from the therapy“ (Tzaan 2007).
Risks
As with all medications and surgical procedures, there is always a risk of complications. With lower risks than traditional
back surgery, discectomy is considered an appropriate treatment for many patients who suffer from back pain (Boswell
2007). The most common complaint is mild back pain at the injection site shortly after the procedure. Other more serious
and far less common complications include spinal cord compression, excessive intracranial pressure, bleeding,
hematoma, or infection. These particular risks are decreased by the use of x-ray and sterile technique.
Outcome
The American Society of Interventional Pain Physicians developed a large evidence-based practice guideline for the
management of chronic spinal pain with interventional techniques. The 2007 article stated that for percutaneous
discectomy using the Dekompressor resulted in greater than 70% improvement in pain in 79% of patients undergoing the
treatment for postero-lateral disc herniations. (Boswell 2007). The reduction in pain allows patients to experience
enough relief to become active again. Often patients regain the ability to resume their normal daily activities.
If you are suffering from chronic back or neck pain contact Arizona Pain Specialists today to see if you can benefit from
this advanced treatment.
Journal Articles
Interventional techniques: evidence-based practice guidelines in the management of chronic spinal pain. Boswell MV,
Trescot AM, Datta S, Schultz DM, Hansen HC, Abdi S, Sehgal N, Shah RV, Singh V, Benyamin RM, Patel VB,
Buenaventura RM, Colson JD, Cordner HJ, Epter RS, Jasper JF, Dunbar EE, Atluri SL, Bowman RC, Deer TR, Swicegood
JR, Staats PS, Smith HS, Burton AW, Kloth DS, Giordano J, Manchikanti L; American Society of Interventional Pain
Physicians. Pain Physician. 2007 Jan;10(1):7-111 PMID: 17256025
Transforaminal percutaneous endoscopic lumbar discectomy. Tzaan WC. Chang Gung Med J. 2007 May-Jun;30(3):226-
34 PMID: 17760273
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Percutaneous Discectomy
by Nicole Berardoni M.D, Paul Lynch M.D, and Tory McJunkin M.D
Percutaneous Discectomy also known as Dekompressor (Stryker)
is a non-surgical, effective treatment for back and neck pain
associated with herniated disc disease. The pain relief
associated with this therapy is due to decompression of the
spinal discs and facet joints, thus reducing the pressure exerted
onto the spinal cord and nerve roots causing pain (Boswell
2007). Separating each individual spinal vertebrae are discs that
act as cushions to minimize the impact that the spinal column
receives. Since the discs are designed to be soft and provide
support, they have a tendency to herniate posteriorly (bulge
backwards) through the outer disc segment and ligaments.
These bulging discs can cause irritation to the adjacent nerves.
by Nicole Berardoni M.D, Paul Lynch M.D, and Tory McJunkin M.D
Percutaneous Discectomy also known as Dekompressor (Stryker)
is a non-surgical, effective treatment for back and neck pain
associated with herniated disc disease. The pain relief
associated with this therapy is due to decompression of the
spinal discs and facet joints, thus reducing the pressure exerted
onto the spinal cord and nerve roots causing pain (Boswell
2007). Separating each individual spinal vertebrae are discs that
act as cushions to minimize the impact that the spinal column
receives. Since the discs are designed to be soft and provide
support, they have a tendency to herniate posteriorly (bulge
backwards) through the outer disc segment and ligaments.
These bulging discs can cause irritation to the adjacent nerves.
Stryker's Dekompressor (image used with permission)
Book I - Pain Syndromes
Chapter 1 Low Back Pain
Chapter 2 Neck Pain
Chapter 3 Cancer Pain
Chapter 4 Headaches
Chapter 5 Spinal Stenosis
Chapter 6 Sciatica
Chapter 7 Arthritis
Chapter 8 Fibromyalgia
Chapter 9 Motor Vehicle Injuries
Chapter 10 Complex Regional Pain
Syndrome
Chapter 11 Vertebral Body
Fractures
Chapter 12 Hip and Leg Pain
Chapter 13 Diabetic Peripheral
Neuropathy
Book II - Interventional Procedures
Chapter 14 Epidural Steroid
Injection
Chapter 15 Facet Injections/Medial
Branch Blocks
Chapter 16 Radiofrequency Ablation
Chapter 17 Spinal Cord Stimulator
Implants
Chapter 18 IntraDiscal
Electrothermal Therapy (IDET)
Chapter 19
Vertebroplasty/Kyphoplasty
Chapter 20 Discography
Chapter 21 Percutaneous
Discectomy
Chapter 22 Occipital Nerve Block
Chapter 23 Sympathetic Block
Chapter 24 Stellate Ganglion Block
Chapter 25 Intrathecal Pump
Implants
Chapter 26 Caudal Steroid Injection
Chapter 27 Adhesiolysis
Chapter 28 Cervical Steroid
Injection
Chapter 29 Sacroiliac Joint
Injections
Chapter 30 Celiac Plexus Block
Chapter 31 Head and Neck
Procedures
Chapter 32 Joint Injections
Chapter 33 Continuous Catheter
Nerve Blocks
Chapter 34 Peripheral Nerve
Stimulation/Field Stimulation
Chapter 35 Disc Denervation
Book III Other Treatments
Chapter 36 Medication Management
Chapter 37 Acupuncture
Chapter 38 Prolotherapy
Chapter 39 Botox
Chapter 40 Massage
Chapter 41 Alternative and
Complementary Medicines
Chapter 42 Exercise and Nutrition
Counseling
Chapter 43 Prayer
Chapter 44 Cognitive Behavioral
Therapy
Chapter 45 Group Therapy
Chapter 46 Biofeedback
Chapter 47 Chiropractic
Manipulations
Chapter 48 Vitamin Supplements
Chapter 49 Customized
Pharmaceutical Formulations
Chapter 50 Hormone Therapy
Frequently Asked Questions
Chapter 1 Low Back Pain
Chapter 2 Neck Pain
Chapter 3 Cancer Pain
Chapter 4 Headaches
Chapter 5 Spinal Stenosis
Chapter 6 Sciatica
Chapter 7 Arthritis
Chapter 8 Fibromyalgia
Chapter 9 Motor Vehicle Injuries
Chapter 10 Complex Regional Pain
Syndrome
Chapter 11 Vertebral Body
Fractures
Chapter 12 Hip and Leg Pain
Chapter 13 Diabetic Peripheral
Neuropathy
Book II - Interventional Procedures
Chapter 14 Epidural Steroid
Injection
Chapter 15 Facet Injections/Medial
Branch Blocks
Chapter 16 Radiofrequency Ablation
Chapter 17 Spinal Cord Stimulator
Implants
Chapter 18 IntraDiscal
Electrothermal Therapy (IDET)
Chapter 19
Vertebroplasty/Kyphoplasty
Chapter 20 Discography
Chapter 21 Percutaneous
Discectomy
Chapter 22 Occipital Nerve Block
Chapter 23 Sympathetic Block
Chapter 24 Stellate Ganglion Block
Chapter 25 Intrathecal Pump
Implants
Chapter 26 Caudal Steroid Injection
Chapter 27 Adhesiolysis
Chapter 28 Cervical Steroid
Injection
Chapter 29 Sacroiliac Joint
Injections
Chapter 30 Celiac Plexus Block
Chapter 31 Head and Neck
Procedures
Chapter 32 Joint Injections
Chapter 33 Continuous Catheter
Nerve Blocks
Chapter 34 Peripheral Nerve
Stimulation/Field Stimulation
Chapter 35 Disc Denervation
Book III Other Treatments
Chapter 36 Medication Management
Chapter 37 Acupuncture
Chapter 38 Prolotherapy
Chapter 39 Botox
Chapter 40 Massage
Chapter 41 Alternative and
Complementary Medicines
Chapter 42 Exercise and Nutrition
Counseling
Chapter 43 Prayer
Chapter 44 Cognitive Behavioral
Therapy
Chapter 45 Group Therapy
Chapter 46 Biofeedback
Chapter 47 Chiropractic
Manipulations
Chapter 48 Vitamin Supplements
Chapter 49 Customized
Pharmaceutical Formulations
Chapter 50 Hormone Therapy
Frequently Asked Questions