Percutaneous Hydrodiscectomy

Herniated disc negatively affects social life, significantly reduces work performance, and impairs mental health due to uncomfortable living. Even though there are many treatment options for the disease, excessive surgical intervention deprives patients of herniated disc both from their health and from their jobs.

Yeditepe University Specialized Hospital Algology Department Prof. Dr. İlhan Öztekin states that patients with lumbar hernia can return to their normal lives in a much shorter time with the painless and bladeless "Percutaneous Hydrodistectomy" method.

What we were wondering about the Percutaneous Hydrodistectomy Method, We asked Prof. Dr. İlhan Öztekin.

What is Percutaneous Hydrodiscectomy Method?

In this method, lumbar hernia can be treated by breaking the material we call the disc between the vertebrae with water and aspirating it from the same canal, thanks to high technology. Hydrodiscectomy, which is a minimally invasive method, is successfully applied in Yeditepe University Hospital Algology Department. It is a new method that came to our country from America. The disc is reached under fluoroscopy with a specially developed needle, and the disc is emptied by disintegrating it with pressurized salt water. The hernia can be removed with 3-5 minutes of water pressure application. Hydrodistectomy, which is a percutaneous procedure performed with special needles without a blade, is a closed and local anesthesia treatment and there are no stitches. The processing time is on average 30-45 minutes. In suitable cases, the success rate is between 85 and 95 percent. The patient can return to home 2-3 hours after the procedure, and to work after 3-5 days of home rest.

What is fluoroscopy, for what purpose is it used here?

Fluoroscopy is an X-ray application. Since the procedure is a closed method, treatment is performed with the help of indirect x-rays. The operation of the place and process entered with x-ray is followed.

Can you talk about the characteristics of the water used?

The water used is medical saline, 0.9 percent NaCl (Sodium Chloride) solution, that is, sterile saline.

In which patients is the Percutaneous Hydrodiscectomy Method applied?

The method gives successful results in the following patients.

Degenerative disc: Black disc, that is, a worn disc that has lost its water,

Bulging disc: Mild hernias that will not be operated on but are painful. These are hernias that do not improve despite physical therapy and injection.

Disc protrusion: An advanced and large hernia without ruptured membrane. These hernias also cause constant pain and do not heal with physical therapy,

Small extruded hernias: Hernias with a small tear in the hernia membrane but no loss of strength in the leg. This method is a strong alternative for patients who do not want to have surgery.

In which patients is Percutaneous Hydrodiscectomy Method not applied?

Generally, this treatment is not applied to patients who have ruptured hernia fragment and fallen into the spinal canal, that is, those who have “sequestration hernia”, patients with foot drop in standing, and patients with tumors in the spinal canal.

How many years has this method been used in the world and in our country?

This method has been applied to approximately 75,000 patients in the USA since 2000. Currently, it is becoming increasingly common in most European countries except the USA, and in the far east in South Korea and China. In 2013, I attended a training on the subject at the Boston hospital, USA, and then I applied this method in approximately 230 patients from 2013 until today. I was one of the first to apply this method in our country, and I presented the results of my own patient practices at three international "Pain Congress" held in Europe and our country.

What are the advantages of Percutaneous Hydrodiscectomy over other methods?

• It is a painless and bladeless procedure,
• The risk is low
• It is done with local anesthesia,
• The risk of surgical complications such as infection, bleeding and late adhesion is very low,
• The process takes an average of 30 minutes,
• The recurrence probability of hernia is very low compared to surgery,
• Treatment is done with a day-long hospitalization (3 hours on average) in the hospital,
• After the treatment, 2-3 days of rest is usually sufficient according to the surgery,
• It shows a success rate of about 90 percent in appropriate cases,
• Afterwards, there is usually no need to use medication.

What should the patient pay attention to before and after the operation?

Since it disrupts blood coagulation, we stop the drugs of those who use blood thinners about 5 days before the surgery. They can take their medication again immediately after the procedure. Starting from the fifth day after the surgery, we help them strengthen their waist and back muscles by giving them some back exercises. In addition, we offer solutions to this problem with a dietitian for those with overweight problems.

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