We operate less and less herniated discs. And soon, some promising techniques will take precedence over “classic” surgery.
Laser “surgery”
This is the so-called nucleolysis-laser technique. Performed by interventional radiologists, it is used for herniated discs of medium size, which do not compress the nerve. Under local anesthesia and radiological control, the radiologist introduces, through the skin, an optical fiber less than one millimeter thick, and places it in the center of the damaged disc. Then the laser emitted by this fiber destroys, by heating (painless), the center of the disc. Which removes the hernia.
The intervention requires less than half-day hospital stay. The convalescence lasts one month. Good results in 70 to 80% of cases.
Gel injection in the disk
This involves injecting an ethanol gel, marketed as Discogel®, directly into the damaged intervertebral disc. The gel then forms a kind of flexible prosthesis and gives shape to the disc. The gel then forms a kind of flexible prosthesis and gives shape to the disc.
This treatment diminishes pain in 70 to 90% of patients. However, some doctors fear that the perforation of the disc to inject the gel worsens the condition of the disc. A clinical trial of this treatment should soon be launched at the Lariboisière Hospital in Paris.
Surgery is essential if the herniated disc is so important that it induces sciatica “hyperalgic”, with intolerable and disabling pain, resistant to all other treatments.
Surgery is also the only solution in certain situations requiring emergency intervention: sciatica paralyzing the foot, difficulty in urinating or bowel movements, etc.
