Minimally Invasive Surgery

Minimally Invasive Intradiscal Procedures

Targeted Disc Surgery Through Tiny Openings

When a spinal disc becomes painful or damaged, not every patient needs a full fusion or open surgery. Minimally invasive intradiscal procedures are designed to treat the disc itself through small incisions, reducing pain and restoring function with less disruption. At Desert Spine and Pain, neurosurgeon Dr. David L. Greenwald, M.D., FAANS, FACS offers multiple intradiscal options, carefully choosing the right procedure based on the type of disc problem, your symptoms, and your long-term goals.

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Over 30 Years Experience in Orthopedic & Neuro Spine Surgeries.

What Are Intradiscal Procedures?

  • In simple terms: These are surgeries that treat the inside of the disc (the “cushion” between bones) through a tiny incision, often using a needle or tube.

  • Scientifically: Intradiscal procedures involve accessing the nucleus pulposus and/or annulus fibrosus using minimally invasive techniques to reduce pressure, seal tears, or deliver biologics, with the goal of relieving radicular pain and/or discogenic back pain.

Conditions Treated

  • Contained herniated discs (disc bulges not fully ruptured)

  • Annular tears causing discogenic pain

  • Degenerative disc disease with disc height loss or internal disruption

  • Chronic low back pain linked to a specific painful disc

Types of Minimally Invasive Intradiscal Procedures

1. Intradiscal Electrothermal Therapy (IDET)

  • How it works (simple): A heated catheter seals small tears in the disc wall, reducing nerve irritation.

  • How it works (science): A flexible catheter is placed into the annulus fibrosus under fluoroscopic guidance; heat (90–100°C) denatures collagen, contracts fibers, and coagulates nociceptive nerve endings.


2. Percutaneous Disc Decompression (Nucleoplasty / Discoplasty)

  • How it works (simple): A special probe removes or shrinks disc material to relieve nerve pressure.

  • How it works (science): Coblation, laser, or mechanical aspiration removes a small portion of nucleus pulposus, lowering intradiscal pressure and decompressing nerve roots.


3. Intradiscal Biologic Injections (Emerging)

  • How it works (simple): Concentrated biologic material (e.g., PRP or stem cells) is injected into the disc to promote healing.

  • How it works (science): Biologics modulate inflammation, promote extracellular matrix synthesis, and may improve disc hydration and function.


The Procedure: Step by Step

Plain-English overview

  1. Anesthesia: Usually local anesthesia with sedation (outpatient).

  2. Small incision/needle access: Using X-ray guidance, we place a needle or small tube into the disc.

  3. Treatment: Depending on the procedure, heat, energy, or biologics are applied.

  4. Closure: No stitches needed in most cases; a bandage is placed.

  5. Recovery: Patients go home the same day, usually walking out of the clinic.

Surgeon-level detail

  • Positioning: Prone or lateral; fluoroscopy ensures precise level targeting.

  • Access: 18–19 gauge spinal needle or small cannula advanced into nucleus pulposus/annulus.

  • Therapy delivery:

    • IDET: Catheter advanced circumferentially; heating cycle performed.

    • Nucleoplasty: Coblation wand activated to ablate and remove nucleus material.

    • Biologics: PRP/stem cell concentrate injected under sterile technique.

  • Closure: Sterile dressing; no sutures.

Benefits

  • Outpatient procedure; quick recovery

  • Smaller incision than open surgery

  • Preserves spinal stability

  • Relief from pain in properly selected patients

  • May delay or prevent the need for fusion

Risks & Limitations

  • Infection, bleeding, nerve irritation (rare)

  • Discitis (serious but uncommon infection risk)

  • Effectiveness varies; best for contained herniations, not large extrusions

  • Not appropriate for severe stenosis, instability, or advanced degeneration

Recovery Timeline

  • Day of procedure: Up walking, home same day

  • Week 1–2: Light activity; mild soreness possible

  • Weeks 2–6: Gradual return to work and exercise

  • 3–6 months: Maximal benefit usually observed as tissue heals and inflammation subsides

Why Choose Desert Spine and Pain?

  • Expert patient selection – We only recommend intradiscal procedures when they’re proven beneficial for your condition

  • Neurosurgeon-led care – Dr. Greenwald ensures safe, precise, evidence-based treatment

  • Comprehensive options – From non-invasive care to injections to advanced MIS surgery, all under one roof

  • Compassionate guidance – We explain everything clearly, reducing anxiety about new or advanced techniques

Frequently Asked Questions

Are intradiscal procedures the same as spinal fusion?

No. Intradiscal procedures preserve motion by treating the disc itself, whereas fusion permanently joins two bones together.

How long does the relief last?

It varies. Some patients experience years of relief, while others may eventually require additional procedures or fusion.

Is recovery faster than with open surgery?

Yes. Most patients return to work within days to weeks, compared to months for traditional surgery.

Are biologic injections (PRP, stem cells) proven?

Research is ongoing. Some patients benefit, but results are variable, and not all insurance covers these treatments.

How does Desert Spine and Pain approach intradiscal surgery differently?

We combine advanced MIS tools, strict patient selection, and neurosurgical precision to maximize results safely.

Dr. David L. Greenwald, MD

Neuro-Spine Surgeon

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If you’re living with chronic back pain caused by a damaged or degenerative disc, minimally invasive intradiscal procedures may offer the relief you need—without extensive surgery or long recovery times. Dr. Greenwald and his caring team will assess your condition, explain your treatment options, and develop a plan tailored to your specific needs. Every step you take toward advanced, minimally invasive care brings you closer to comfort, mobility, and a better quality of life. Schedule your consultation today and take the first step toward lasting relief.

Voted Best Spine Doctor

Over 30 Years Experience in Orthopedic & Neuro Spine Surgeries.

Dr. David L. Greenwald, M.D., F.A.C.S.

Neurosurgeon | Spine Surgeon | Regenerative Medicine

Dr. David L. Greenwald, MD, FACS, is a board-certified spine surgeon specializing in minimally invasive intradiscal procedures, which are designed to treat painful disc conditions without the need for large incisions or traditional open surgery. These advanced techniques—such as intradiscal electrothermal therapy (IDET), biacuplasty, and regenerative injections—target damaged or degenerated discs directly to relieve pain, reduce inflammation, and restore function. By using specialized tools and image-guided precision, Dr. Greenwald minimizes tissue disruption, speeds up recovery, and helps patients return to their daily activities sooner. His expertise in these cutting-edge procedures has made him a trusted leader in minimally invasive spine care throughout South Florida.

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