Percutaneous discectomy: an alternative to chemonucleolysis?

At the University of Florida, a new technique for lumbar disc removal, called percutaneous discectomy, has been explored. This procedure may be performed under general or local anesthesia, frequently takes less than 15 minutes, and is generally bloodless. The patient selection process and the surgical technique are presented in detail. A total of nine patients have undergone percutaneous discectomy. Seven had clear radiculopathies with appropriate radiographic findings, and they all have had excellent relief of symptoms. Two patients presented with intractable low back pain, bilateral mechanical findings, and central disc herniations on radiographic examination. One experienced good relief and one did not. Three patients had several days of paraspinous spasm after the procedure, and one complained of a lower extremity dysesthetic sensation that persisted for several weeks after operation. Our early experience with percutaneous discectomy suggests that it is a technically easy procedure that may prove, in carefully selected cases, to be a viable alternative to other discectomy techniques.