Text Back PainAs part of a randomized controlled study, experts recently compared between standard conservative therapy and a minimally invasive treatment called percutaneous disc decompression for painful herniated disc. Their results apparently showed that though both treatments aided patients in the short-run, only patients who had undergone disc decompression were pain free up to two years later.

Resting between the bones of the spine, discs are sponge-like cushions. They may cause irritation or pressure on the spinal nerves when they bulge or herniate outwards. This results in a condition known as sciatica which is characterized by back and leg pain and weakness. Before considering other treatments, patients are often recommended by physicians to try six weeks of anti-inflammatory and pain medications.

“Most protocols call for a minimal approach to initially treat a herniated disc. 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 long run,” mentioned Alexios Kelekis, M.D., Ph.D., assistant professor of interventional radiology at the University of Athens in Greece.

Interventional radiologists were found to utilize image guidance to puncture a bulging disc through the skin with a needle for percutaneous disc decompression treatment. They thus claimed to have deflated the disc by either removing some tissue or using energy to dissolve it. Performed on an outpatient basis under local anesthesia, the procedure supposedly allows patients to return to normal activities within 30 days.

To better understand the treatment Dr. Kelekis and colleagues carried out a study, the first of its kind in which they treated tow groups of patients with herniated discs and sciatica that was ratified by MRI. The study involved patients who complained of back and leg pain and had a mean age of 36. There were 17 men and 14 women. It was observed that both the groups had earlier tried various traditional treatments that were apparently not successful.

The first group was administered six weeks of rigorous conservative therapy consisting of analgesics, anti-inflammatory drugs and muscle relaxants. At th end of the treatment, this group reported to have reduced pain and enhanced mobility. Percutaneous disc decompression treatment was given to the second group. Patients in both groups on completion of treatment were clinically checked and also filled in a questionnaire tailored to evaluate pain relief, quality of life and mobility improvement. This assessment would be at intervals of three months, 12 months and 24 months later

At the three-month interval, apparently both the groups of patients reported pain reduction and increased mobility. Nearly one year and two years post treatment, patients who were subjected to disc decompression appeared to show continuous improvement. Patients who had reportedly received only conservative therapy claimed that their pain had returned and their mobility had also decreased.

“Up until 12 months following therapy, both groups of patients were doing great,” Dr. Kelekis mentioned. “But by 12 months beyond treatment, patients who received only conservative therapy had returned to their initial pain levels.”
Only herniated discs that are not ruptured or too compressed are the ones suited for percutaneous disc decompression.

The findings were recently presented at the annual meeting of the Radiological Society of North America (RSNA).