What is percutaneous disc removal? Percutaneous disc removal is the removal of the nucleus pulposus from the spinal canal under imaging surveillance to reduce the pressure on the intervertebral disc and to use the elastic modulus of the annulus fibrosus to return the displaced disc tissue to relieve the symptoms of nerve compression. Advantages of percutaneous disc removal In addition to the advantages of less trauma, shorter operation time, faster recovery, and no interference with the internal structure of the spinal canal, the anterior approach allows a wide range of movement of the working trocar and direct decompression, as well as clear observation of the nucleus pulposus morphology and bleeding in the incision and aspiration channel. Mechanism of percutaneous puncture disc nucleus pulposus removal for herniated discs. It is generally believed that percutaneous puncture disc nucleus pulposus removal is performed mainly through small openings in the disc fibrous annulus and partial removal of the nucleus pulposus, which reduces the pressure in the disc, thus relieving the irritation of nerve roots and nociceptive receptors around the disc, thus achieving the purpose of eliminating symptoms. 1.Significantly reduce the intra-disc pressure: Because the intervertebral disc itself has obvious volume-elastic modulus characteristics, when the nucleus pulposus is removed after drilling in the annulus fibrosus, the intra-disc pressure can be significantly reduced from 24 kPa to 2.624 kPa, but the degenerative degeneration of the intervertebral disc is severely changed, resulting in significant narrowing of the intervertebral space, and the elastic modulus of the intervertebral disc is significantly reduced, in this case, the efficacy of percutaneous perforation disc myelotomy is In such cases, the efficacy of percutaneous percutaneous disc nucleotomy is not good. 2.Reducing the content of the herniated part of the disc: In percutaneous puncture disc myelotomy, not only can the central part of the disc nucleus pulposus be removed, thus achieving the purpose of indirect decompression, but also part of the herniated part of the nucleus pulposus can be removed. 3, change the direction of the herniated nucleus pulposus: percutaneous puncture disc myelotomy not only removes the partial nucleus pulposus through the lateral approach, but also drills and opens a window on the posterior side of the intervertebral disc’s fibrous ring, so that the local fibrous ring’s inclusion of the nucleus pulposus disappears, and the existence of this window artificially changes the direction of the herniated nucleus pulposus, which plays an important role in the long-term sustainable decompression of the intervertebral disc. Indications for percutaneous disc removal 1, lumbar spine ①, sciatica, the patient does have low back pain, leg pain must be more intense than lumbar pain. ②, lower limb sensory and motor disorders. ③, positive spinal nerve compression signs, such as a positive straight leg raise test. ④. After imaging examination such as CT or MRI, the imaging manifestations are consistent with specific clinical symptoms and confirmed as simple disc herniation, or may be accompanied by vertebral body posterior margin osteophytes or articular protrusion, but the diagnosis of disc herniation is confirmed as the main compressive factor. ⑤, after 6 weeks of conservative treatment with poor results, or although the history of the disease is short, but the pain is large, the patient firmly requested treatment. 2, cervical spine The clinical signs and symptoms of cervical spondylosis caused by degenerative changes of the cervical disc are more complex, and it is common to see a mixed type with complex performance between each type clinically. We propose, based on our practical work experience: ①, cervical disc herniation, whose symptoms and signs match with CT and MRI performance. ②, cervical disc herniation caused by spinal cord type, nerve root type and sympathetic nerve type cervical spondylosis, without combined bony spinal stenosis, without posterior longitudinal ligament calcification and yellow ligament hypertrophy. ③, those who have been ineffective by conservative treatment for 2 months.