Provocative Discography- Coupled with CT scan
It is a kind of test that determines the culprit disc which is giving you pain or compressing the nerve leading to sciatica or other nerve pain. This test also gives an indication of success of any treatment that you receive for your disc problem. So this is the initial step in the assessment of your back pain problem. In this test spine specialist gives a special medicines into the suspected problematic disc (which may or may not be looking as herniated disc on MRI), that reproduces the same pain for few minutes confirming the diagnosis and help in deciding the right treatment.
Percutaneous Disc Decompression (PDD)
After diagnosing the level of painful offending disc various minimally – invasive, non – surgical intradiscal treatments can be given with pinhole camera techniques.
Ozone Discectomy: An innovative, least invasive, safe & effective alternative to spine surgery, is the treatment of choice for bulging disc (PIVD) done under local anaesthesia in a day care setting. This treatment is ideally suited for cervical (neck) & lumbar (back) disc bulging with radicular pain. Patients can pursue their routine work after 24 hours. All these facts have made this procedure very popular at western countries. It is also becoming popular in our country due to high success rate, less invasiveness, fewer chances of recurrence, remarkably fewer side effects meaning high safety, short hospital stay, no post operative discomfort or morbidity and low cost.
If despite the ozone treatment the symptoms persist, Percutaneous intradiscal decompression can be done via pin hole camera technique or X-rays guided MIPI (Minimally – Invasive Pain Relief Intervention), like Laser or Coblation Nucleoplasty/ Biacuplasty/ Disc-FX / Endoscopic Discectomy. These are good alternatives before open surgical discectomy which has to be contemplated in some true emergencies.
In BIACUPLASTY radiofrequency energy is used through needle like instruments to heat & shrink the disc & making it harder as well as able for weight bearing. In COBLATION NUCLEOPLASTY energy is used with same technique to evaporate the jelly-like disc material thereby debulking to create space for disc to remodel itself.
A pen like instrument mechanically cuts & drills out the disc material, debulking the disc, reducing nerve compression. It is a brilliant technique to cure back pain, Sciatica & Cervical | neck pain. It comes in different sizes for lumbar discs & for cervical discs.
Disc-FX & Endoscopic Decompression (PEDD)
In this novel technique a wide bore needle like instrument is inserted from some distance from spine, making the treatment safer. This way we can directly target the herniated part of the disc through the rupture part of outer covering of the disc. Disc is then mechanically extracted with forceps to release the pinched nerve. Then the painful & sensitive outer covering of the disc is sealed & thermo-ablated with radiofrequency which also seals the defect to prevent & decrease recurrences.
Next Higher procedure, ENDOSCOPIC DISCECTOMY is done with endoscope or in other words through pin hole camera technique. Mostly done under local anaesthesia, it’s fast becoming standard of care for disc bulge, herniated disc, disc protrusion & extrusions causing spinal canal stenosis with root or cord compression with leg pain. No cut or incision is given. Patient is discharged from the hospital same day or at the maximum next day. It is obviously much safer than open surgery and can be accomplished with one third of the cost of open major surgery.
Laser Discectomy is an outpatient procedure with one-step insertion of a needle into the disc space. Disc material is not removed; instead, jelly-like, inner material of disc (nucleus pulposus) is removed by eliminating it by the laser. Laser discectomy is minimally invasive, cost-effective, and free of postsurgical pain, and it is starting to be more widely used at various centers.
Epiduroscopic laser neural decompression with flexible thread like camera, is considered an effective treatment alternative for chronic refractory low back and/or leg pain, including lumbar disc herniation, lumbar spinal stenosis, and failed back surgery syndrome that cannot be treated with existing noninvasive non-surgical treatments. This Procedure is done under vision via an epiduroscope inserted via Caudal canal or Transforaminally employing front or side firing Laser &/or fine instruments.