Minimally Invasive Percutaneous Mechanical Discectomy for Lumbar Disc Herniation: A Case Report and Technical Insight

Minimally Invasive Percutaneous Mechanical Discectomy for Lumbar Disc Herniation: A Case Report and Technical Insight | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Minimally Invasive Percutaneous Mechanical Discectomy for Lumbar Disc Herniation: A Case Report and Technical Insight Dott. Francesco Saturno, Dott. Emidio Cianciola, Dott. Giulia Monaco, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7091382/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background : Low back pain is one of the leading causes of disability worldwide and contributes significantly to healthcare costs. Among its most common etiologies is lumbar disc herniation, often associated with radicular symptoms and reduced quality of life. Objective : This article presents a case of symptomatic L3-L4 lumbar disc herniation treated with a minimally invasive percutaneous discectomy technique. We describe the procedural steps and assess the patient's clinical outcomes over a one-year follow-up. Methods : A 38-year-old patient with persistent radicular pain and dysesthesia underwent percutaneous discectomy using a bipolar radiofrequency system, enabling decompression, ablation, and annular modulation in a single procedure. The technique was performed under fluoroscopic guidance. Results : Postoperative evaluation at 7 days, 3 months, 6 months, and 1 year showed complete resolution of symptoms and progressive clinical improvement, with no complications. Conclusion : The described percutaneous discectomy technique appears safe and effective for selected patients with contained lumbar disc herniation. Further studies are needed to validate long-term outcomes and define standardized indications. Figures Figure 1 Figure 2 Figure 3 Introduction Low back pain remains one of the most prevalent and disabling conditions globally, representing a significant burden on healthcare systems and society. Approximately 80% of the adult population in industrialized countries experiences at least one episode during their lifetime. Over the past decade, the number of spinal surgical procedures has markedly increased, partly due to population aging and advancements in diagnostic imaging. One of the primary causes of low back pain and radiculopathy is lumbar disc degeneration, which can lead to nucleus pulposus herniation, local inflammation, or nerve root compression. While conservative therapy remains effective in about 60% of cases, a subset of patients requires surgical intervention to achieve symptomatic relief. The traditional surgical approach—open discectomy—aims to decompress the nerve root and alleviate pain. However, in recent years, numerous minimally invasive techniques have emerged, including percutaneous mechanical and laser discectomy, as shown in figure 1. These procedures aim to reduce tissue damage and recovery time, while maintaining efficacy. Despite encouraging results and good patient acceptance, these techniques have encountered skepticism in parts of the surgical community. Among them, endoscopic foraminal discectomy has gained widespread recognition. In this article, we present a case of lumbar herniation treated with a percutaneous mechanical discectomy system, describing the technique in detail and reporting clinical follow-up. Case Description A 38-year-old male patient presented with persistent right-sided radicular pain and dysesthesia in the lower limb. MRI (T1, T2, STIR sequences) revealed a right foraminal L3-L4 lumbar disc herniation, with preservation of the nucleus pulposus. The patient initially underwent a cycle of image-guided epidural steroid injections, which provided only partial and temporary relief. Given the persistence of symptoms and radiological findings, surgical intervention was indicated. The selected procedure was a percutaneous mechanical discectomy using an integrated, minimally invasive radiofrequency-based system capable of core decompression, nuclear ablation, and annular modulation. Surgical Technique Step 1 – Needle Insertion and Discography: A 16G spinal needle was inserted through Kambin’s triangle into the proximal third of the L3-L4 disc space. A discogram was performed using a mixture of contrast agent, saline, and indigo carmine dye in a 6:3:1 ratio. Step 2 – Guidewire Placement: A guidewire was advanced through the needle into the disc nucleus, and correct placement was verified fluoroscopically. Step 3 – Skin Incision and Cannula Introduction: After a small incision with a No. 11 scalpel, the needle was removed, and a dilator-cannula assembly was introduced over the guidewire. As shown in Figure 2, a lumbar foramen dilator was inserted through the lateral access under fluoroscopic control. Step 4 – Anulotomy and Cannula Advancement: An anulotomy was performed using a drill advanced through the annulus. Once the working portal was established, the guidewire and dilator were removed. Step 5 – Manual Discectomy: A 2.7 mm grasping forceps was inserted through the cannula to manually remove approximately 1–2 grams of nuclear material. The excised tissue was collected for pathological examination. Step 6 – Nucleus Ablation: Radiofrequency ablation was performed using a bipolar probe with settings at 25W (Bipolar Turbo mode). Energy was delivered in six 6-second pulses at clock positions. Step 7 – Annular Modulation: Using the bipolar coagulation mode (25W), the same probe was applied along the annular wall in a sawing motion. This step aimed to contract collagen fibers and treat nociceptors. The system operated at low temperatures (up to 41°C in the nucleus, 32.5°C in the annulus), ensuring thermal safety and preserving adjacent structures. No intraoperative complications were observed. Funding Postoperative Follow-Up and Outcome The patient was evaluated at 7 days, 3 months, 6 months, and 1 year postoperatively. He reported complete resolution of radicular pain and dysesthesia, with progressive and stable clinical improvement over time. No recurrence or complications were noted. Conclusion Minimally invasive percutaneous mechanical discectomy represents a promising alternative to conventional surgery for selected patients with contained lumbar disc herniation. The described technique combines core decompression, ablation, and annular modulation in a single, fluoroscopically guided session, ensuring precision and safety. Although open microdiscectomy remains the gold standard due to its reproducibility and outcomes, percutaneous approaches are gaining attention for their reduced invasiveness, shorter recovery, and low complication rates. However, the evidence base remains limited, and further randomized controlled studies are warranted to define their role in modern spine surgery. Minimally invasive percutaneous discectomy techniques have shown promising long-term outcomes in selected patients, as supported by recent studies [8–10,12]. Declarations All participants signed a written informed consent to publish their clinical case. Funding This research received no external funding. References Manchikanti L, Kaye AD, Knezevic NN, et al. Efficacy of Percutaneous Disc Decompression in the Management of Lumbar Disc Herniation: A Systematic Review. Pain Physician. 2020;23(2):137-154. Mobbs RJ, Rao PJ. Minimally invasive lumbar discectomy: current practice and future developments. J Spine Surg. 2019;5(Suppl 1):S42–S50. Kim HS, Chung CK, Jahng TA, Kim HJ. Percutaneous lumbar discectomy: review of current concepts and indications. World Neurosurg. 2018;112:374-384. Zeng C, Li H, Yang T, et al. Comparison of minimally invasive and open discectomy for lumbar disc herniation: a meta-analysis of randomized controlled trials. Int J Surg. 2018;56:320-329. Gibson JNA, Waddell G. Surgical interventions for lumbar disc prolapse: updated Cochrane Review. Spine (Phila Pa 1976). 2007;32(16):1735-1747. Choy DS. Percutaneous lumbar discectomy. Neurosurg Clin N Am. 1995;6(3):423-428. Casper GD. Indications and contraindications for minimally invasive spine surgery. Spine (Phila Pa 1976). 2010;35(26 Suppl):S254–S261. Muto M, Zanirato A, Migliorini F. Minimally invasive percutaneous lumbar discectomy: indications and long-term outcomes. Eur Spine J. 2022;31(9):2225-2235. Ryang YM, Narvid J, Albers GW, et al. Endoscopic transforaminal lumbar discectomy: A systematic review and meta-analysis of clinical outcomes. Neurosurg Focus. 2021;50(1):E5. Choi KC, Shim HK, Ryu KS, et al. Long-term clinical outcomes of percutaneous endoscopic lumbar discectomy in patients with lumbar disc herniation: a minimum 5-year follow-up study. Pain Physician. 2020;23(5):E487-E495. Lee CH, Kim YS, Kwon BK, et al. Radiofrequency nucleoplasty for lumbar disc herniation: clinical outcomes and safety profile. J Pain Res. 2021;14:1073-1081. Manchikanti L, Boswell MV, Singh V, et al. Comprehensive evidence-based guidelines for interventional techniques in the management of chronic spinal pain. Pain Physician. 2009;12(4):699–802. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7091382","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":484010312,"identity":"c47833ff-92e4-48f9-a96b-998763282c85","order_by":0,"name":"Dott. Francesco Saturno","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+klEQVRIiWNgGAWjYBAC9gZk3ocKGyDJ2HgAnxYeJFnGxhln0kB0A/FamnnbDoNZ+LVIH3724EdFnTw//+HnD2ecOW+3tv0w0JYam2icWvjSzA17zhw2nDkjzbDhQ8Xt5G1nEoFajqXlNuDQYs/DYCbN2HYgweAGgyHQL7eTzQ4AtTA2HMaphYeH/Zs047+6BIPzxz8C/XIu2ez8Q0JaeIC2NDAnGBzIMQRqOWBndoOgLTxlkj3HQH7JKZw540xygtkNoC0JePwCdNg2iR81oBA7vuHDhwo7e7Pz6Q8ffKixwakFAySCVSYQqxwE7ElRPApGwSgYBSMDAAB3bmVoCU0ShwAAAABJRU5ErkJggg==","orcid":"","institution":"Asl Salerno","correspondingAuthor":true,"prefix":"","firstName":"Dott.","middleName":"Francesco","lastName":"Saturno","suffix":""},{"id":484010313,"identity":"c3f61fa1-b3b0-415e-98ae-ff0aecfae02e","order_by":1,"name":"Dott. Emidio Cianciola","email":"","orcid":"","institution":"Asl Salerno","correspondingAuthor":false,"prefix":"","firstName":"Dott.","middleName":"Emidio","lastName":"Cianciola","suffix":""},{"id":484010314,"identity":"0af38348-36bb-4524-8f10-cbe2f56077da","order_by":2,"name":"Dott. Giulia Monaco","email":"","orcid":"","institution":"Asl Salerno","correspondingAuthor":false,"prefix":"","firstName":"Dott.","middleName":"Giulia","lastName":"Monaco","suffix":""},{"id":484010315,"identity":"c3091ce5-3e90-4d84-a952-ba6669b8bf62","order_by":3,"name":"Angela Salerno","email":"","orcid":"","institution":"University of Campania \"Luigi Vanvitelli\"","correspondingAuthor":false,"prefix":"","firstName":"Angela","middleName":"","lastName":"Salerno","suffix":""},{"id":484010316,"identity":"7c46963d-ba27-444d-b870-17b12d5db02d","order_by":4,"name":"Antonio Cianciola","email":"","orcid":"","institution":"Saint Camillus International University of Health and Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Antonio","middleName":"","lastName":"Cianciola","suffix":""}],"badges":[],"createdAt":"2025-07-10 09:38:03","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7091382/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7091382/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":86670052,"identity":"4e732581-3d7a-4e14-8fa7-cb8957ba1f44","added_by":"auto","created_at":"2025-07-14 11:26:10","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":1137839,"visible":true,"origin":"","legend":"\u003cp\u003eshows the spinal needle positioning under fluoroscopic guidance during the percutaneous discectomy procedure.\u003c/p\u003e","description":"","filename":"11.png","url":"https://assets-eu.researchsquare.com/files/rs-7091382/v1/6c636b23948c1ddf8e5e969b.png"},{"id":86670974,"identity":"f0340fbb-b2e7-4284-8c7b-a8a88cbf3b88","added_by":"auto","created_at":"2025-07-14 11:34:10","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":1835709,"visible":true,"origin":"","legend":"\u003cp\u003eThe operator is inserting a lumbar foramen dilator through a lateral percutaneous access under fluoroscopic guidance. The real-time fluoroscopic image on the monitor shows a lateral projection, allowing verification of the correct trajectory and depth of the instrument within the intervertebral foramen.\u003c/p\u003e","description":"","filename":"22.png","url":"https://assets-eu.researchsquare.com/files/rs-7091382/v1/b89ef7d8f0226b8c2ef436d8.png"},{"id":86670051,"identity":"9df92aa4-6a53-4e6f-b415-7cb4bcbc4eca","added_by":"auto","created_at":"2025-07-14 11:26:10","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":799253,"visible":true,"origin":"","legend":"\u003cp\u003eLateral fluoroscopic view showing the insertion of a dilator into the intervertebral foramen during a minimally invasive percutaneous procedure. The instrument is precisely positioned under imaging guidance to allow access to neural or discal structures, facilitating the subsequent therapeutic phase. The correct trajectory and depth of the dilator are confirmed by the visualization of adjacent bony landmarks.\u003c/p\u003e","description":"","filename":"33.png","url":"https://assets-eu.researchsquare.com/files/rs-7091382/v1/6bea7a4b28e8f7dcabf46da5.png"},{"id":86929691,"identity":"8f6a7000-3ae0-44c8-8b29-2c8c3458fc36","added_by":"auto","created_at":"2025-07-17 09:23:42","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":4615333,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7091382/v1/43143b69-5a9b-470f-8f9d-a60f769d456c.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Minimally Invasive Percutaneous Mechanical Discectomy for Lumbar Disc Herniation: A Case Report and Technical Insight","fulltext":[{"header":"Introduction","content":"\u003cp\u003eLow back pain remains one of the most prevalent and disabling conditions globally, representing a significant burden on healthcare systems and society. Approximately 80% of the adult population in industrialized countries experiences at least one episode during their lifetime. Over the past decade, the number of spinal surgical procedures has markedly increased, partly due to population aging and advancements in diagnostic imaging.\u003c/p\u003e\n\u003cp\u003eOne of the primary causes of low back pain and radiculopathy is lumbar disc degeneration, which can lead to nucleus pulposus herniation, local inflammation, or nerve root compression. While conservative therapy remains effective in about 60% of cases, a subset of patients requires surgical intervention to achieve symptomatic relief.\u003c/p\u003e\n\u003cp\u003eThe traditional surgical approach\u0026mdash;open discectomy\u0026mdash;aims to decompress the nerve root and alleviate pain. However, in recent years, numerous minimally invasive techniques have emerged, including percutaneous mechanical and laser discectomy, as shown in figure 1. These procedures aim to reduce tissue damage and recovery time, while maintaining efficacy.\u003c/p\u003e\n\u003cp\u003eDespite encouraging results and good patient acceptance, these techniques have encountered skepticism in parts of the surgical community. Among them, endoscopic foraminal discectomy has gained widespread recognition. In this article, we present a case of lumbar herniation treated with a percutaneous mechanical discectomy system, describing the technique in detail and reporting clinical follow-up.\u003c/p\u003e"},{"header":"Case Description","content":"\u003cp\u003eA 38-year-old male patient presented with persistent right-sided radicular pain and dysesthesia in the lower limb. MRI (T1, T2, STIR sequences) revealed a right foraminal L3-L4 lumbar disc herniation, with preservation of the nucleus pulposus.\u003cbr\u003e \u003cbr\u003e The patient initially underwent a cycle of image-guided epidural steroid injections, which provided only partial and temporary relief. Given the persistence of symptoms and radiological findings, surgical intervention was indicated.\u003cbr\u003e \u003cbr\u003e The selected procedure was a percutaneous mechanical discectomy using an integrated, minimally invasive radiofrequency-based system capable of core decompression, nuclear ablation, and annular modulation.\u003c/p\u003e\n\u003ch2\u003eSurgical Technique\u003c/h2\u003e\n\u003cp\u003eStep 1 \u0026ndash; Needle Insertion and Discography: A 16G spinal needle was inserted through Kambin\u0026rsquo;s triangle into the proximal third of the L3-L4 disc space. A discogram was performed using a mixture of contrast agent, saline, and indigo carmine dye in a 6:3:1 ratio.\u003cbr\u003e \u003cbr\u003e Step 2 \u0026ndash; Guidewire Placement: A guidewire was advanced through the needle into the disc nucleus, and correct placement was verified fluoroscopically.\u003cbr\u003e \u003cbr\u003e Step 3 \u0026ndash; Skin Incision and Cannula Introduction: After a small incision with a No. 11 scalpel, the needle was removed, and a dilator-cannula assembly was introduced over the guidewire. As shown in Figure 2, a lumbar foramen dilator was inserted through the lateral access under fluoroscopic control.\u003c/p\u003e\n\u003cp\u003eStep 4 \u0026ndash; Anulotomy and Cannula Advancement: An anulotomy was performed using a drill advanced through the annulus. Once the working portal was established, the guidewire and dilator were removed. \u003c/p\u003e\n\u003cp\u003eStep 5 \u0026ndash; Manual Discectomy: A 2.7 mm grasping forceps was inserted through the cannula to manually remove approximately 1\u0026ndash;2 grams of nuclear material. The excised tissue was collected for pathological examination.\u003cbr\u003e \u003cbr\u003e Step 6 \u0026ndash; Nucleus Ablation: Radiofrequency ablation was performed using a bipolar probe with settings at 25W (Bipolar Turbo mode). Energy was delivered in six 6-second pulses at clock positions.\u003cbr\u003e \u003cbr\u003e Step 7 \u0026ndash; Annular Modulation: Using the bipolar coagulation mode (25W), the same probe was applied along the annular wall in a sawing motion. This step aimed to contract collagen fibers and treat nociceptors.\u003cbr\u003e \u003cbr\u003e The system operated at low temperatures (up to 41\u0026deg;C in the nucleus, 32.5\u0026deg;C in the annulus), ensuring thermal safety and preserving adjacent structures. No intraoperative complications were observed. Funding\u003c/p\u003e\n\u003ch2\u003ePostoperative Follow-Up and Outcome\u003c/h2\u003e\n\u003cp\u003eThe patient was evaluated at 7 days, 3 months, 6 months, and 1 year postoperatively. He reported complete resolution of radicular pain and dysesthesia, with progressive and stable clinical improvement over time. No recurrence or complications were noted.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eMinimally invasive percutaneous mechanical discectomy represents a promising alternative to conventional surgery for selected patients with contained lumbar disc herniation. The described technique combines core decompression, ablation, and annular modulation in a single, fluoroscopically guided session, ensuring precision and safety.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Although open microdiscectomy remains the gold standard due to its reproducibility and outcomes, percutaneous approaches are gaining attention for their reduced invasiveness, shorter recovery, and low complication rates. However, the evidence base remains limited, and further randomized controlled studies are warranted to define their role in modern spine surgery. Minimally invasive percutaneous discectomy techniques have shown promising long-term outcomes in selected patients, as supported by recent studies [8\u0026ndash;10,12].\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cspan\u003eAll participants signed a written informed consent to publish their clinical case.\u003c/span\u003e\u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e\n\u003cp\u003eThis research received no external funding.\u003c/p\u003e\n"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eManchikanti L, Kaye AD, Knezevic NN, et al. Efficacy of Percutaneous Disc Decompression in the Management of Lumbar Disc Herniation: A Systematic Review. Pain Physician. 2020;23(2):137-154.\u003c/li\u003e\n\u003cli\u003eMobbs RJ, Rao PJ. Minimally invasive lumbar discectomy: current practice and future developments. J Spine Surg. 2019;5(Suppl 1):S42\u0026ndash;S50.\u003c/li\u003e\n\u003cli\u003eKim HS, Chung CK, Jahng TA, Kim HJ. Percutaneous lumbar discectomy: review of current concepts and indications. World Neurosurg. 2018;112:374-384.\u003c/li\u003e\n\u003cli\u003eZeng C, Li H, Yang T, et al. Comparison of minimally invasive and open discectomy for lumbar disc herniation: a meta-analysis of randomized controlled trials. Int J Surg. 2018;56:320-329.\u003c/li\u003e\n\u003cli\u003eGibson JNA, Waddell G. Surgical interventions for lumbar disc prolapse: updated Cochrane Review. Spine (Phila Pa 1976). 2007;32(16):1735-1747.\u003c/li\u003e\n\u003cli\u003eChoy DS. Percutaneous lumbar discectomy. Neurosurg Clin N Am. 1995;6(3):423-428.\u003c/li\u003e\n\u003cli\u003eCasper GD. Indications and contraindications for minimally invasive spine surgery. Spine (Phila Pa 1976). 2010;35(26 Suppl):S254\u0026ndash;S261.\u003c/li\u003e\n\u003cli\u003eMuto M, Zanirato A, Migliorini F. Minimally invasive percutaneous lumbar discectomy: indications and long-term outcomes. Eur Spine J. 2022;31(9):2225-2235.\u003c/li\u003e\n\u003cli\u003eRyang YM, Narvid J, Albers GW, et al. Endoscopic transforaminal lumbar discectomy: A systematic review and meta-analysis of clinical outcomes. Neurosurg Focus. 2021;50(1):E5.\u003c/li\u003e\n\u003cli\u003eChoi KC, Shim HK, Ryu KS, et al. Long-term clinical outcomes of percutaneous endoscopic lumbar discectomy in patients with lumbar disc herniation: a minimum 5-year follow-up study. Pain Physician. 2020;23(5):E487-E495.\u003c/li\u003e\n\u003cli\u003eLee CH, Kim YS, Kwon BK, et al. Radiofrequency nucleoplasty for lumbar disc herniation: clinical outcomes and safety profile. J Pain Res. 2021;14:1073-1081.\u003c/li\u003e\n\u003cli\u003eManchikanti L, Boswell MV, Singh V, et al. Comprehensive evidence-based guidelines for interventional techniques in the management of chronic spinal pain. Pain Physician. 2009;12(4):699\u0026ndash;802.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-7091382/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7091382/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: Low back pain is one of the leading causes of disability worldwide and contributes significantly to healthcare costs. Among its most common etiologies is lumbar disc herniation, often associated with radicular symptoms and reduced quality of life.\u003cbr\u003e\n\u003cstrong\u003eObjective\u003c/strong\u003e: This article presents a case of symptomatic L3-L4 lumbar disc herniation treated with a minimally invasive percutaneous discectomy technique. We describe the procedural steps and assess the patient's clinical outcomes over a one-year follow-up.\u003cbr\u003e\n\u003cstrong\u003eMethods\u003c/strong\u003e: A 38-year-old patient with persistent radicular pain and dysesthesia underwent percutaneous discectomy using a bipolar radiofrequency system, enabling decompression, ablation, and annular modulation in a single procedure. The technique was performed under fluoroscopic guidance.\u003cbr\u003e\n\u003cstrong\u003eResults\u003c/strong\u003e: Postoperative evaluation at 7 days, 3 months, 6 months, and 1 year showed complete resolution of symptoms and progressive clinical improvement, with no complications.\u003cbr\u003e\n\u003cstrong\u003eConclusion\u003c/strong\u003e: The described percutaneous discectomy technique appears safe and effective for selected patients with contained lumbar disc herniation. Further studies are needed to validate long-term outcomes and define standardized indications.\u003c/p\u003e","manuscriptTitle":"Minimally Invasive Percutaneous Mechanical Discectomy for Lumbar Disc Herniation: A Case Report and Technical Insight","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-14 11:26:05","doi":"10.21203/rs.3.rs-7091382/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d829378a-1698-4292-8094-fb523374aa72","owner":[],"postedDate":"July 14th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-07-17T09:23:17+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-14 11:26:05","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7091382","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7091382","identity":"rs-7091382","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}