What is Disc Denervation?
Disc denervation is performed on patients who suffer from a chronic history of back pain. During the procedure, physicians treat discogenic pain by using heated radiofrequency electrodes to destroy the nerves that are causing pain. After the problematic nerves are deactivated, they are unable to transmit pain signals to the brain. Pain-sensing chemicals, known as neuropeptides, are typically released through the nerves; however, radiofrequency denervation causes a complete disruption of this process.
This physical and chemical change to the disc has been shown in several medical studies to be effective as a non-invasive option to back surgery. Statistics reflect the popularity of this procedure. Since 1998, more than 75,000 disc denervation procedures have been performed in the United States. Successful disc denervation ultimately results in a reduction of back pain for the patient as well as an improvement in mobility and overall quality of life.
How is Disc Denervation Performed?
First, the patient is positioned face-down on an x-ray table and the skin is sterilized and prepared for the procedure. If sedation is needed, it will be delivered through an IV and vital signs such as blood pressure, heart rate, and breathing will be monitored throughout the procedure.
A radiofrequency needle is inserted and guided to the precise location using a real time x-ray. During this process, known as fluoroscopy, dye, which can be seen on a monitor, is injected to help physicians pinpoint the exact location where treatment is needed. Once the correct nerves have been identified, electrical stimulation is initiated through the needle. The heat from the radiofrequency needle will then denervate the nerves in the location of the painful disc. At the conclusion of the procedure, a band-aid is placed over the location of the injection site. The entire procedure takes less than an hour.
Comprehensive research studies have indicated that disc denervation procedures are effective in 60% to 70% of patients with chronic discogenic pain. The studies have also shown that patients who benefit from disc denervation have increased mobility, physical function, and dramatic improvements in quality of life after the procedure.
Disc denervation is a minimally invasive procedure; however, as with all procedures, there is still some potential risk of complications. Although rare, potential complications include bleeding, infection, and nerve damage.
Conditions Related to Disc Denervation
Patients that have had discogenic-related pain for at least six months without relief from other conservative treatments are candidates for disc denervation. Disc pain is one of the most common sources of back pain and can be caused by bulging or herniated discs, degenerative disc disease, spinal stenosis, and other conditions. To better understand discogenic pain, let’s take a closer look at the anatomy of spinal discs.
The spine is composed of 33 interlocking vertebrae. These bones of the spine are connected by facet joints. They are separated by discs, which help bring mobility to the spine. The discs absorb the wear and tear and impact on the spine. In this capacity, they act like shock-absorbers to the spine. The outer part of the disc is composed of fibers, known as annulus fibrous. These tough membranes contain a nucleus, which is a soft, jelly-like substance.
When the jelly-like substance degenerates, the blood supply to the disc stops and the nucleus begins to harden. At the same time, the outer membrane begins to weaken and makes the disc prone to injury. Most of the time, degenerative disc disease is associated with the normal process of aging.
Disc herniation can also be caused by normal wear and tear or through a traumatic injury. During herniation, the nucleus bulges out past the fibrous capsule and causes aggravation to the surrounding nerve receptors. These inflamed nerves then send pain signals to the brain. Herniated discs in the cervical area can result in pain, tingling, or numbness in the arms and hands, while herniated discs in the lower back may result in pain, tingling, or numbness in the legs and feet.
Evidence has shown that disc denervation remains a conservative option to help pain specialists eliminate discogenic pain in the spine without the use of invasive back or neck surgery. This well-researched nonsurgical treatment has been the subject of many studies that have shown favorable results concerning its safety and efficacy.