Procedure of the Month

You Chose Selection #5:
Decompression only right L5-S1 via MicroDiscectomy

YOU ARE CORRECT!

In this case, decompression of the right S1 nerve root via a HydroDiscectomy™ is the best choice.  This procedure addresses the patient’s radicular pain which is 90% of her symptoms with an outpatient procedure.  Given her age and the fact that back pain only comprised 10% of her symptoms, fusion or disc arthroplasty should be avoided at this time.  As she ages, if her back pain worsens after HydroDiscectomy, fusion or disc arthroplasty can de revisited in the treatment algorithm.

HydroDiscectomy utilizes the SpineJet® MicroResector to remove disc material through a 4mm cannula system.  The SpineJet MicroResector uses high velocity water to pulverize the disc material and remove tissue through an evacuation tube in a controlled and safe manner.  It has many advantages over standard MicroDiscectomy techniques.

First, the cannula system has been designed to minimize the residual annular defect after decompression.  The working cannula is only 4mm and is inserted into the disc space over a dilator rather than cutting the annular fibers.  After decompression, when the cannula is removed, the elasticity of the annular fibers closes the annulotomy.  These factors contribute to minimizing the annulotomy thereby decreasing the rate of potential recurrent herniations.

Second, performing the HydroDiscectomy through a cannula minimizes intraoperative nerve root manipulation.  This decreases the amount of post-operative epidural fibrosis and potential for chronic nerve root irritation in the absence of recurrent herniation.

Third, the SpineJet MicroResector allows the surgeon to remove disc material precisely.  The surgeon has complete control over how much or how little disc material is removed.  This allows the decompression to be performed efficiently.

 

Click here for MicroDiscectomy Surgical Technique