Lumbar
Percutaneous Discectomy
Lumbar percutaneous discectomy is done using a needle-based, minimally invasive technique for the removal of a small piece of leaflet tissue. When performed successfully, it relieves pressure exerted on the nerve due to a disc herniation. It does not cut muscles nor remove bones. In the outpatient setting, most surgeries are performed under local anaesthesia with sedation. The procedure will last around 30-45 minutes. Typically, a patient notices improvement in their leg pain, numbness and mobility from a few days to weeks.
Board Certified
Neurosurgeon
15+ Years
Experience
5000+
Procedures Performed
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WHAT IS A LUMBAR PERCUTANEOUS DISCECTOMY?
The cushions found between the vertebras of the backbone are called discs. Every disc consists of a tough outer ring (the annulus) surrounding an inner soft, gel-like centre (the nucleus). When that outer ring weakens or tears, a piece of the nucleus can push outward and press on a nearby spinal nerve. This disc has herniated or bulged out.
When a nerve becomes compressed in this manner, the resulting pain frequently extends beyond the back. The pain travels down the buttock, the back of the thigh, sometimes going all the way to the foot. Legs can feel weak, numb, or tingle after the pain begins. In the beginning, the discomfort may only occur after prolonged sitting or bending in a particular way. With time, it can begin to impact walking, standing, or sleeping throughout the night.
The lumbar percutaneous discectomy treatment is done by gaining access to the disc through an opening in the skin the size of a needle. This is not done via an open incision but is done by using x-ray live imaging. A herniated disc decompression surgery involves the surgeon removing only a small portion of the disc material. Since the nearby muscle and bone are left undisturbed, the overall recovery process of the body is less.
30–45 Minutes
Same Day Procedure
Local Anesthesia
1–3 Weeks Recovery
What This Procedure Treats
Disc-related nerve compression doesn't always announce itself clearly. For some patients, it starts as an ache that comes and goes with certain movements. For others, it's a sharp, electric pain that won't let them get comfortable in any position. Lumbar Percutaneous Discectomy is designed to treat these symptoms and issues:
01
Sciatica & Radiating Leg Pain
Pain that starts in the lower back or buttock and travels down the leg, often following a specific nerve pathway. Patients frequently describe it as sharper and more electric than typical muscle soreness.
02
Numbness or Tingling in the Leg or Foot
A pins-and-needles sensation, or a patch of skin that feels dull or "asleep," usually tracing the path of the compressed nerve rather than the whole leg.
03
Lower Back Pain from a Contained Disc Herniation
Persistent low back pain confirmed on imaging to be coming from a disc bulge, rather than from muscle strain, arthritis, or another spinal structure.
04
Leg or Foot Weakness
Trouble lifting the front of the foot, pushing off when walking, or noticing one leg tiring faster than the other — signs that the compressed nerve is starting to affect muscle function.
05
Pain That Worsens with Sitting, Bending, or Coughing
Increased pressure on the disc during these activities often makes nerve-related pain spike, which is one of the more telling signs of a disc-driven problem.
06
Symptoms That Persist Despite Rest and Conservative Care
When time, activity modification, and physical therapy haven't moved the needle, it's often because the disc material is still pressing on the nerve and needs to be physically relieved.
Ready to Move Without Pain?
Find out whether Lumbar Percutaneous Discectomy is the right treatment for your symptoms.
When Patients Become Candidates
Lumbar percutaneous discectomy is rarely the first step. Most people with a herniated disc improve with conservative care — rest, physical therapy, anti-inflammatory medication, or an epidural steroid injection to calm the inflammation around the nerve. When those measures stop working, or never worked well enough, this procedure becomes a reasonable next option for the right candidate.
No Lasting Relief from Conservative Treatment
Physical therapy and steroid injections are typically tried first. When relief is partial or short-lived despite consistent effort, it's a sign the disc itself still needs to be addressed.
Sciatica That Won't Let Up
Leg pain that continues for six or more weeks without meaningful improvement, despite rest and at-home care, is one of the clearer signals that the nerve compression needs a direct fix.
Imaging confirms a contained disc herniation.
An MRI showing a focal, contained disc bulge (not a large extruded fragment; not significant nerve issues) is probably the best fit for percutaneous disc approach.
Pain That's Limiting Daily Function
Having constant pain which makes it difficult to sit through the workday, sleep through the night or walk distances that used to be easy, suggests a level of nerve irritation which is unlikely to resolve on its own.
Wanting to Avoid Open Surgery
Being not a candidate for open discectomy, or just wanting to try the least invasive choice first, many patients start here, before considering something more operatively invasive.
Diagnostic Testing Supports the Diagnosis
The relationship between symptoms, physical examination findings, and MRI imaging will greatly influence the consideration of percutaneous discectomy being helpful for a particular patient.
Key Benefits
Targeted Relief at the Source
Rather than masking pain, the procedure addresses the disc material that's actually compressing the nerve, which is why relief tends to be more direct than with medication alone.
No Cutting of Muscle or Bone
Because the spine is accessed through a needle rather than an incision, there's no muscle dissection and no bone removal — a major reason recovery tends to move faster.
Minimal Scarring
The access point is roughly the size of a needle puncture, not a surgical incision, which means little to no visible scarring afterward.
Faster Return to Activity
Most patients are walking the same day and resuming light daily activities within a week or two, well ahead of the typical timeline for open surgery.
Outpatient Procedure Under Local Anesthesia
You come in, have the procedure, and go home the same day. General anesthesia is typically not required.
Spinal Stability Is Preserved
Because no bone, ligament, or facet joint is removed, the natural movement of the spinal segment stays intact — no fusion is needed.
What Happens During the Procedure
Positioning & Anesthesia
You're positioned on your stomach, and the skin over the treatment area is numbed with local anesthetic. Light sedation is typically used so you stay comfortable and relaxed throughout.
Imaging-Guided Needle Placement
Using real-time x-ray (fluoroscopy), a thin needle is guided to the targeted disc through a small natural opening between the spinal structures, avoiding the need for any incision.
Accessing the Disc
The needle is advanced into the outer portion of the disc using a posterolateral approach, reaching the herniated material without disturbing the surrounding muscle, bone, or nerve.
Confirming Position
Before any tissue is removed, imaging confirms the needle is exactly where it needs to be. This step is what keeps the procedure precise and safe.
Removing or Decompressing Disc Material
A small amount of the herniated nucleus material is removed or decompressed through the needle. This is the core of the procedure — once pressure inside the disc drops, pressure on the nerve drops with it.
Confirming Decompression
Imaging is used again to confirm the nerve has more room and that no additional disc material is contributing to the compression.
Going Home
A bandage is placed over the small puncture site — no stitches are usually needed. After a short observation period, most patients go home within a couple of hours. No overnight hospital stay is required.
Why Choose Capital Spine & Pain Institute
Fellowship-Trained Neurosurgeon
Dr. Buchholz completed subspecialty training in spine and minimally invasive surgery. This isn't a general orthopedic practice.
Conservative-First Philosophy
We prioritize non-surgical treatment first. If physical therapy or an injection can resolve your symptoms, that's the path we'll recommend.
Imaging-Guided Precision
Every procedure is guided by real-time imaging and supported by a clear correlation between your symptoms and your MRI findings before we move forward.
Honest Evaluations
If a percutaneous approach isn't the right fit for your herniation, we'll tell you — and explain what would be a better option instead.
What to expect week by week
Recovery varies, but here's how most patients progress.
Same Day
Go home. Rest.
Procedure done. Mild soreness at the needle site is normal. Skip driving — you'll need a ride home.
24–48 Hours
Soreness fades.
Site soreness clears quickly. Walking is encouraged as soon as you're comfortable; many patients notice early pain relief starting here.
1 Week
You should feel a difference.
Most patients see a meaningful reduction in leg and back pain. Light daily activities are usually back on the table.
2–4 Weeks
Return to normal routines.
Most patients resume work and regular activity, though heavy lifting, bending, and twisting are still limited while the disc settles.
Weeks–Months
Continued improvement.
Numbness and lingering nerve symptoms can take longer to fully resolve, since nerves heal gradually. Physical therapy can help support the recovery during this stretch.
Expert Spine Surgeon
Dr. Avery L. Buchholz is a board-certified neurosurgeon with fellowship training in complex spine surgery. With over 15 years of experience and 5,000+ procedures performed, he specializes in both minimally invasive and complex surgical techniques.
His expertise spans the full spectrum of spine care, from non-surgical interventions to advanced reconstructive procedures, always prioritizing patient safety and optimal outcomes.
Frequently Asked Questions
Get answers to common questions about our practice and procedures
What Is a Lumbar Percutaneous Discectomy?
It is a bit like unblocking a ruptured pipe. A needle is directed to the disc and a little of the bulging material is drawn away so that the nerve next to it has space again.
How much time does the procedure take?
The total time taken ranges from 30 to 45 minutes.
Will I be conscious throughout the surgery?
In most cases, yes, with light sedation. Beforehand, your area is numbed, so you shouldn’t feel the needle placement or the disc work itself.
Does the procedure hurt?
Not at any time. It's usual to have some slight soreness at the needle site for one or two days afterwards, which can be controlled through over-the-counter drugs.
When am I able to return to work?
Desk jobs typically enable return to work in a few days to a week. Jobs entailing physical actions like lifting, bending, or twisting often need a few weeks longer.
How is this discectomy different from a microdiscectomy or open surgery?
A percutaneous discectomy is done through a needle and with the help of imaging – no incisions are made. This is a recommended surgical procedure for smaller and contained disc herniations only. Microdiscectomy is performed through a small incision under direct visualization, and is mostly performed for larger herniations or when more disc material is to be removed.
Our Locations
Serving patients across VA and the DC area
Falls Church, VA
6400 Arlington Blvd, Suite 710
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Alexandria, VA
6244A Little River Turnpike
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Richmond, VA
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Charlottesville, VA
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Washington, DC
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Get In Touch
Contact us today to schedule your consultation and take the first step toward relief.
Address
6244 Little River Turnpike, Suite 101
Alexandria, VA 22312
Phone
FAX
Office Hours
Monday - Friday: 9:00 AM - 6:00 PM
Saturday: 9:00 AM - 6:00 PM
Sunday: Closed
This form is intended for scheduling purposes only and is not a HIPAA-compliant form. Please avoid sharing any sensitive medical information.
By submitting, you consent to being contacted using the information provided.
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