These treatments reduce the disc by a very small fraction, only about 1/20th of the volume of the nucleus pulposus. However, studies have shown that this results in a dramatic reduction of intradiscal pressure to normal levels. I have performed these procedures in all areas of the spine including cervical (neck), thoracic (mid back), and lumbar (lower back). These treatments can take only about 15 minutes to perform, and can produce a permanent improvement in pain. Patients walk out of the center about an hour later, and some report an immediate relief of pressure in their back. This treatment is an excellent option for patients with small contained disc herniations and discogenic pain of other causes. I have effectively and permanently treated hundreds of patients with these modalities thus avoiding open surgery. A video which depicts the procedure can be seen here: https://youtu.be/16TknhL-yGs
Endoscopic discectomies involve placement of an endo scope at the area of the disc herniation. This is connected to a fiberoptic cable and a large television screen. Therefore, the abnormal area can be examined under direct visualization. I can see if the disc herniation is pressing on the nerve root, or if there is any compromise of the neuroforamen or spinal canal. Various tools can be used to treat the condition. A grasper is used to remove a small amount of the disc herniation, a rhizotomy device to seal any annular tears which exist, and additionally a drill is available to remove excess bone to open up the nerve canal, and reduce impingement. The ultimate result is to reduce the disc herniation and any nerve impingement which exist. The benefits of this are a small incision, less chance of scar formation, less postoperative discomfort, and a lower recuperative time.
In conclusion, many different conditions of the spine involving disc herniations and nerve impingement can be treated with either percutaneous disc decompression or an endoscopic discectomy. There are a great deal of benefits of these minimally invasive therapies over open surgery. These are permanent treatments that have less risk of complications versus open surgery, as well as less postoperative discomfort and less recovery time.