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.