Name of the Procedure:

Catheter, Intradiscal (HCPCS Code: C1754)

Common Name: Intradiscal catheter placement
Technical/Medical Term: Intradiscal catheterization

Summary

An intradiscal catheter procedure involves the insertion of a catheter into a spinal disc. This can be used for diagnostic purposes or to deliver treatments directly to the disc, such as medications or regenerative therapies.

Purpose

Medical Conditions: The procedure addresses conditions such as herniated discs, degenerative disc disease, and chronic back pain.
Goals: The primary goal is to relieve pain, reduce inflammation, or promote healing within the spinal disc.

Indications

Symptoms/Conditions: Severe back pain, nerve pain, or sciatica that has not responded to conservative treatments.
Patient Criteria: Typically appropriate for patients experiencing chronic pain linked to specific spinal disc issues confirmed by imaging studies.

Preparation

Instructions: Patients may be instructed to fast for several hours before the procedure and adjust certain medications.
Pre-Procedural Tests: Imaging studies such as MRI or CT scans to identify the affected disc.

Procedure Description

1. Patient Positioning: The patient lies on their stomach.
2. Local Anesthesia: The area where the catheter will be inserted is numbed.
3. Initial Incision: A small incision is made at the site.
4. Guide Needle: A guide needle is inserted and advanced to the affected disc using fluoroscopic guidance.
5. Catheter Placement: The catheter is threaded through the needle to the disc.
6. Treatment Delivery: Medication or other therapies are delivered through the catheter.
7. Removal: The catheter and needle are removed, and the incision is closed.

Tools/Equipment: Fluoroscopy, guide needle, intradiscal catheter.
Anesthesia: Local anesthesia is typically used; sedation may be provided if necessary.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

This procedure is usually performed in an outpatient clinic or a surgical center.

Personnel

Healthcare team typically includes:

• Interventional radiologist or spine specialist
• Nurse
• Radiologic technologist
• Anesthesiologist (if sedation is required)

Risks and Complications

Common Risks: Pain at the injection site, bleeding, infection.
Rare Risks: Nerve damage, allergic reaction to contrast dye or medications, worsening of symptoms.

Benefits

Expected Benefits: Pain relief, reduced inflammation, improved mobility.
Realization Time: Patients may experience pain relief within a few days to a few weeks.

Recovery

Post-Procedure Care: Patients are usually monitored for a short period before being discharged. They may need to avoid strenuous activities for a few days.
Recovery Time: Typically, patients can resume normal activities within a few days. Follow-up appointments may be necessary to assess the effectiveness of the treatment.

Alternatives

Other Treatments: Physical therapy, oral medications, epidural steroid injections, surgical options like discectomy or spinal fusion.
Pros and Cons: Alternatives might be less invasive but also may not provide as direct and potentially effective relief as the intradiscal catheter procedure.

Patient Experience

During Procedure: Patients might feel mild pressure or discomfort, but pain is usually minimal due to local anesthesia.
After Procedure: Some soreness at the injection site is common. Pain management includes over-the-counter pain relievers and instructions for rest and limited activity as needed.