Low back pain with radiating leg pain—often called sciatica—is commonly caused by a lumbar disc herniation pressing on a nerve root. For many patients, symptoms improve with physical therapy, medications, or epidural steroid injections. But when conservative care helps only temporarily and surgery feels like too big of a step, percutaneous disc decompression may be an excellent option.
At Horizon Spine and Pain of Utah, this procedure has become an important option for carefully selected patients who want something less invasive than a discectomy but more definitive than repeat injections.
What Is Percutaneous Disc Decompression?
Percutaneous disc decompression is a minimally invasive, image-guided procedure designed to relieve pressure on a spinal nerve caused by a contained disc herniation. Using a specialized tool such as the Stryker DeKompressor, a small amount of disc material is removed from inside the disc. This reduces internal disc pressure and allows the herniated portion to retract away from the nerve.
The procedure is performed in the outpatient clinic, takes about 20–30 minutes, uses local anesthesia with light sedation, and requires only a needle-sized entry point. No bone or muscle is cut during the procedure.
How the Procedure Works
The intervertebral disc acts like a cushion between the vertebrae. When the inner material herniates outward, it can press on a nerve root. During percutaneous decompression, a needle is placed into the disc under live X-ray guidance. The decompression device removes a small amount of inner disc material, lowering pressure and allowing the herniation to retract away from the nerve. Because no bone or outer disc structure is removed, the spine's stability is preserved.
Who Is a Good Candidate?
This procedure is best suited for patients with:
- •A contained lumbar disc herniation
- •Unilateral leg pain
- •Symptoms that match MRI findings
- •Temporary relief from epidural steroid injections
- •A desire to avoid or delay surgery
Patients are encouraged to consult with a neurosurgeon or spine surgeon first to fully understand their surgical options. If surgery is recommended but the patient prefers a less invasive approach, percutaneous decompression may be considered.
A Real-World Patient Example
Recently, an amateur golfer came into our clinic with a large lumbar disc herniation causing severe pain down one leg. The disc was not extruded or sequestered, making him a potential candidate for minimally invasive treatment.
He had already seen a surgeon, who recommended a microdiscectomy. However, he was very hesitant about undergoing anesthesia and surgery. He had received two epidural steroid injections, which worked extremely well but only temporarily. After discussing all options, including risks, benefits, and alternatives, he chose to proceed with percutaneous disc decompression.
The procedure was performed in the clinic using sterile technique, antibiotics, live X-ray guidance, local anesthesia, and moderate sedation. The entire procedure took about 20 minutes.
He noticed reduced pressure in his leg immediately after the procedure. Within several days, his symptoms improved significantly. He returned to golfing within three to four weeks, and at two months, he reported no back pain or leg pain.
Patient name and identifying details have been changed for privacy.
Why Some Patients Choose This Over Surgery
Traditional microdiscectomy or open discectomy requires general anesthesia, removal of part of the bone, and removal of portions of the disc. While surgery has excellent outcomes, it can increase spinal instability, accelerate degenerative changes, and require a longer recovery.
Percutaneous decompression does not remove bone or damage the outer disc. It removes only inner disc material, preserving the natural anatomy of the spine.
Recovery and Rehabilitation
Most patients go home the same day and are encouraged to perform light activity. Heavy lifting and bending are limited initially. We strongly recommend two to four months of structured physical therapy to strengthen the core, stabilize the spine, and reduce the risk of re-herniation.
Insurance Coverage
The procedure is FDA-approved but is typically not covered by insurance due to limited large-scale trials. It is usually a cash-pay procedure, though HSA and FSA funds are typically eligible.
Research and Evidence
Clinical studies suggest that percutaneous disc decompression can reduce leg pain, improve function, and delay or avoid surgery in selected patients. While the evidence is not as extensive as for open surgery, outcomes in properly selected patients are encouraging.
Contact Information
- •Dr. Devan Partridge — Horizon Spine and Pain of Utah
- •📍 15 S. 1000 E. #250, Payson, UT 84651
- •📞 Phone: 385-298-1008
- •📧 Email: frontdesk@horizonpainutah.com
- •🌐 Website: www.horizonpainutah.com
References
- •Alò K et al. Percutaneous lumbar discectomy: clinical response in an initial cohort of 50 consecutive patients with chronic radicular pain. Pain Practice. 2004; 4(1):19-29.
- •Alò K et al. Percutaneous lumbar discectomy: one-year follow-up in an initial cohort of 50 consecutive patients with chronic radicular pain. Pain Practice. 2005; 5(2):116-123.
- •Amoretti N et al. Clinical follow-up of 50 patients treated by percutaneous lumbar discectomy. Clinical Imaging. 2006; 30(4):242-244.
- •Buenaventura R et al. Systematic review of discography as a diagnostic test for spinal pain: an update. Pain Physician. 2007; 10(1):147-164.