Minimally invasive disc treatment gives long-term relief from
chronic back pain
2 December 2009
A comparison of standard medication-based therapy to a
minimally invasive treatment called percutaneous disc decompression for
painful herniated disc revealed that while both treatments help patients
in the short run, only disc decompression kept patients pain free up to
two years later.
Results of the study, the first of its kind, were presented at the
annual meeting of the Radiological Society of North America (RSNA) this
In percutaneous disc decompression, interventional radiologists use
image guidance to puncture a bulging disc through the skin with a needle
and deflate the disc by either removing some tissue or using energy to
dissolve it. The procedure is performed on an outpatient basis under
local anaesthesia, and patients are usually able to return to normal
activities within 30 days.
Discs are sponge-like cushions that rest between the bones of the
spine. When a disc bulges or herniates outward, it can cause irritation
or pressure on the spinal nerves, resulting in a condition known as
sciatica. Sciatica is characterized by back and leg pain and weakness.
Physicians often recommend that patients try six weeks of
anti-inflammatory and pain medications before considering other
|MR image of spine one year after treatment for a herniated
protocols call for a minimal approach to initially treat a herniated
disc," said Alexios Kelekis, M.D., Ph.D., assistant professor of
interventional radiology at the University of Athens in Greece. "But by
deflating the disc and giving the nerve root the space it needs, disc
decompression solves the problem of root irritation and prevails in the
In this study, Dr. Kelekis and colleagues treated two groups of
patients with herniated discs and sciatica confirmed by MRI. Both groups
included 17 men and 14 women complaining of back and leg pain. The mean
age of patients was 36.
Both groups had tried different conservative treatments in the past
without success. The first group, which received six weeks of rigorous
conservative therapy consisting of analgesics, anti-inflammatory drugs
and muscle relaxants, reported pain reduction and improved mobility at
the end of treatment. The second group underwent percutaneous disc
Upon completion of treatment, patients in both groups were clinically
evaluated and completed a questionnaire designed to assess pain relief,
quality of life and mobility improvement at intervals of three months,
12 months and 24 months later.
Both patient groups reported pain reduction and increased mobility at
the three-month interval. However, one year and two years after
treatment, patients who had undergone disc decompression continued to
improve, while patients who received only conservative therapy reported
that their pain had returned and their mobility had decreased.
"Up until 12 months following therapy, both groups of patients were
doing great," Dr. Kelekis said. "But by 12 months beyond treatment,
patients who received only conservative therapy had returned to their
initial pain levels."
Percutaneous disc decompression is suitable only for herniated discs
that are not ruptured or too compressed.