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Percutaneous Disc Decompression

Indication: Lumbar or Cervical Disc Herniation

Over 400,000 spine surgeries are performed each year in the United States. A majority of these surgeries are conducted for lumbar disc herniation. Traditionally, neurosurgical and orthopedic techniques for lumbar disc herniation include lumbar laminectomy, discectomy, and lumbar fusion. A significant number of patients end up with so-called “failed back surgery syndrome”. Recurrent disc herniation, epidural abscess, scar tissue formation around nerve roots, facet joint syndrome, and muscle spasm may contribute to the clinical features of this syndrome. To avoid possible complications of open surgery, minimal invasive techniques for disc decompression have been developed. These techniques include Chymopapain, Nucleotome, laser discectomy, Nucleoplasty, and Disc DeKompressor. Chymopapain is a proteolytic enzyme from the Papaya fruit. This enzyme may induce enzymatic decompression of the nucleus pulposus of the herniated disc. Initial clinical reports were highly positive. However, due to its serious side effects, such anaphylactic shock, transverse myelitis and even death, chymopapain has been largely replaced by other techniques.

Percutaneous Nucleotome was developed by a Japanese orthopedic surgeon, Dr. Hijikata in 1975. This procedure inserts a 7-mm-diameter tube into the annulus and removes the disc material with specially designed forceps. This procedure has a reported success rate of 72%. However, due to the large diameter of the cannula, this technique is no longer commonly used.

Ascher and Choy introduced YAG laser discectomy in 1986. This is still being commonly used by spine surgeons, neurosurgeons and some interventional pain specialists. This technique utilizes an 18 G probe, and generates laser energy to evaporate part of the nucleus pulposus. It decreases the intradiscal pressure with a reported success rate for back pain relief of 78% to 80%. Due to heat generated by the laser energy, patients may experience severe pain during the procedure and increased muscle spasm after the procedure.

Laser spine surgery has been over marketed over the last decade. The results of the surgery may not as good as it has been marketed. Patients may want to have a second opinion before you commit a large amount of cash for the surgery, when the results are not guaranteed.

Meet the FLPNR Team

  • Richard Adkins, MD
  • Hoang (Wayne) T. Vu, D.O.
  • Lourdes Varela–Batista, M.D.
  • Vinh-Loc Nguyen, P.A.
  • Irene Aponte Moreno, N.P.
  • Sunny Park, N.P.
Anesthesiology Specialist in Ocala, FL Doctor of Osteopathic Medicine in Ocala, FL Physician in Ocala, FL Physician in Ocala, FL Nurse Practitioner in Ocala, FL Nurse Practitioner in Ocala, FL
Anesthesiology Specialist in Ocala, FL

Richard Adkins, MD

Anesthesiology Specialist

Dr. Richard Adkins has been in practice for more than 30 years. His specialty is in anesthesiology and pain medicine.

Doctor of Osteopathic Medicine in Ocala, FL

Hoang (Wayne) T. Vu, D.O.

Dr. Hoang (Wayne) T. Vu is board certified by both the American Board of Pain Medicine and the American Board of Physical Medicine and Rehabilitation. Dr. Vu earned his degree of Doctor of Osteopathic Medicine from Touro University College of Osteopathic Medicine in California in 2003.

Physician in Ocala, FL

Lourdes Varela–Batista, M.D.

Dr. Varela is a fellowship trained pain specialist and board certified PMR expert. Her specialities include physical medicine and rehabilitation and interventional pain medicine. She received her undergraduate degree from University of Puerto Rico and completed her medical degree from New York Medica College. Dr. Varela completed her physical medicine and rehabilitation residency at University of Texas Health Science Center San Antonio.

Physician in Ocala, FL

Vinh-Loc Nguyen, P.A.

Vinh-Loc Nguyen is a NCCPA certified physician assistant and is licensed by the State of Florida Department of Health. He received his Bachelor of Science degree in microbiology and Bachelor of Arts Degree in economics from University of Florida in 1994. He had a successful career in the financial industry before returning to his true passion for medicine.

Nurse Practitioner in Ocala, FL

Irene Aponte Moreno, N.P.

Ms. Irene Aponte Moreno is an Adult-Gerontology certified Nurse Practitioner and licensed by the State of Florida Department of Health. In 2014, she received her Master of Science degree in Nursing from the University of South Alabama. She completed her Bachelor of Science degree in Nursing from Jacksonville State University in December of 2006. In 2003, she received an Associates of Arts degree from Southwestern Michigan College. She also completed an Associate degree in Informatics from the University Institute Antonio Jose de Sucre located in Lara State, Venezuela.

Nurse Practitioner in Ocala, FL

Sunny Park, N.P.

Ms. Sunny Park is an AANP and ANCC certified Advanced Registered Nurse Practitioner, licensed by the State of Florida Department of Health. She graduated with Summa Cum Laude with Bachelor of Arts in Drawing from Southern Illinois University in 1999. She pursued nursing career and graduated with Associate of Science in Nursing in 2007 and started working as a registered nurse in Cardiovascular ICU in St.Luke’s Medical Center. She continued with her education and graduated with Magna Cum Laude obtaining Bachelor of Science in Nursing in 2010 from Cardinal Stritch University. During her nursing education, she was awarded multiple scholarships including the Lamplight scholarship by Milwaukee Nurses Association.


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