Tears of the outer disc fibers (fissures), protrusions of the inner disc materials (nucleus cells and proteins) can cause considerable pain, pressure on spinal nerves, and neurologic dysfunction.
If conservative treatment such as physical therapy or precise, x-ray guided steroid injections around the involved nerves fail, then treating the direct cause of the symptoms and nerve dysfunction is necessary for recovery.
This intervention can be used to treat small, contained herniations and tears in the outer layers of the disc (the annulus). There are pain nerve fibers in the annulus and if cells and proteins from the inner disc layers (the nucleus) leak into the central or side canals of the spine, pressure and inflammation can cause pain, weakness, numbness and other abnormal sensations. This technique can treat this in a minimally invasive way avoiding standard surgery with a much longer time for recovery.
This is performed using x-ray guidance in a surgical center with local anesthesia and sedation. A general anesthetic can also be used. It is outpatient, same day surgery.
An endoscope is introduced for direct visualization of the inside of the disc and epidural space. The extent of disc removal and modulation of the outer disc fibers can be determined using the endoscope.
video courtesy of Elliquence, LLC. This will open a Youtube window and requires a sign-in to watch due to the surgical procedure demonstrated.