Percutaneous Discectomy in Houston, Texas
A disc herniation is, in mechanical terms, a pressure problem. Material that should sit inside the disc has migrated outward and is pushing on a nerve. Percutaneous discectomy removes a small volume of that material through a needle, decompressing the disc from the inside.
No incision. No general anesthetic. No fusion.
What is Percutaneous Discectomy?
Percutaneous disc decompression uses a probe advanced into the center of the disc under fluoroscopic guidance to remove or ablate a small amount of nucleus pulposus. Because the disc is a closed hydraulic system, removing even a modest volume from the center reduces intradiscal pressure substantially and allows the bulging portion to retract away from the nerve.
Several technologies accomplish this — mechanical aspiration, nucleoplasty using radiofrequency, and laser — and the choice depends on the disc and the physician's judgment.
| Stage | What happens |
|---|---|
| Before | You're positioned, the skin is cleaned and numbed, and live imaging (fluoroscopy or ultrasound) guides the needle |
| During | The medication is placed precisely at the bulging part of the disc, which is removed through a needle-sized opening; most people feel pressure more than sharp pain |
| After | You rest briefly and go home the same day — arrange a driver if you received sedation |
Who Is a Candidate
Patient selection determines the outcome, and the criteria are strict.
Good candidates have:
- A contained disc herniation — the outer annulus is intact
- Leg pain exceeding back pain
- Imaging findings that match the symptom pattern
- Failure of at least six weeks of conservative treatment
- Preserved disc height
Poor candidates have:
- An extruded or sequestered fragment — the material is no longer contained
- Severe disc height loss
- Significant spinal instability or spondylolisthesis
- Progressive neurological deficit, which needs surgery, not a needle
This is the single most important paragraph on this page. Performed on the wrong patient, the procedure does not work. Performed on the right one, it can eliminate the need for open surgery.