Percutaneous nucleotomy is a new, minimally invasive surgical technique for the gentle treatment of a herniated disc. A herniated disc causes back or neck pain that cannot be alleviated by rest, painkillers and physiotherapy.
A herniated disc in the cervical spine is mainly diagnosed by MRI(magnetic resonance imaging).
Open disc surgery is often accompanied by disc replacement or disc fusion, while percutaneous nucleotomy does not cause the discs to lose their mobility. The method is therefore a less traumatic alternative to open disc surgery.
In addition, percutaneous nucleotomy can also be used in more severe cases, e.g. stenosis.

Percutaneous nucleotomy is a minimally invasive procedure for the treatment of a herniated disc © Henrie | AdobeStock
Surgeons usually perform percutaneous nucleotomy under local anesthesia. The patient therefore remains conscious. The patient is usually discharged from hospital the next day. Younger patients can even be treated on an outpatient basis.
Percutaneous nucleotomy is minimally invasive: the surgeon only makes small incisions in the skin over the affected section of the spine and inserts an endoscope into the body through them. The endoscope is equipped with a camera, a light source and fine instruments. The image from the camera can then be seen live and enlarged on a monitor.
The surgeon uses this image to perform the disc operation using a 2 mm cannula (a microsurgical instrument). To do this, he uses a saw to cut off the bulging part of the disc that is pressing on the nerve. The surgeon then removes the residue using a small suction device. This relieves the pressure on the nerve and the pain disappears.
The operation takes about 45 minutes.
Thanks to the technique used, there is little or no pain after the operation. There are also practically no scars left behind.
- The risks are significantly lower than with open surgery.
- The effectiveness is at least as high as with open surgery.
- Stiffening can be prevented in over 90 percent of cases.
- This procedure does not cause degeneration in the adjacent intervertebral discs, as is the case with fusion.
- Only a small amount of tissue is removed so that the spine remains more stable.
- The procedure is performed under local anesthesia and is therefore much safer than general anesthesia.
- A post-operative neck brace is not necessary.
In most cases, the pain is completely gone after the operation. Painkillers or neck braces are rarely necessary.
A check-up is carried out one day after the operation. The patient is then discharged home. Physiotherapy can begin a week later.
About two to six weeks after the operation, the patient is fully functional again.