Non-Surgical Herniated Disc Treatment

Non-surgical treatments cause less tissue damage, shorten hospital stays, and allow for a quicker return to daily life. Furthermore, they minimize the risks of infection and anesthesia typically seen in classic surgery.

Robotic Laser Disc Regression (Regression) Treatment

The treatment involves placing a laser fiber through a thin catheter, guided by a robotic navigation system, into the disc with a back herniation and partially vaporizing the jelly-like nucleus pulposus of the disc with controlled laser energy. The thermal effect of the laser reduces intradiscal pressure, the herniated mass shrinks, and the pressure on the nerve root and inflammatory response decrease; the robotic arm ensures millimeter-level precision in guiding the needle through the skin-bone line, minimizing the risk of damage to surrounding tissues.

This minimally invasive procedure is usually performed under local anesthesia through a 1–2 mm entry. Patients can often mobilize on the same day after this procedure; it is preferred for herniated disc cases without advanced neurological loss and with an intact outer annulus. The duration of the effect varies depending on the level of herniation, the degree of tissue degeneration, and the patient’s adherence to rehabilitation. Therefore, the treatment plan must be individually evaluated by a relevant specialist physician.

Radiofrequency Dorsal Root Ganglion (DRG) Blockade

It is applied through a thin needle-electrode placed next to the nerve root ganglion emerging from the spinal cord, guided by X-ray (fluoroscopy) or CT. Continuous or pulsed radiofrequency energy sent from the electrode modulates nerve fibers thermally or electrically, reducing pain transmission; thus providing relief that can last for months in cases of low back/neck radicular pain, sciatica, neuropathic pain, and CRPS.

The procedure is typically performed on an outpatient basis under local anesthesia and mild sedation: after confirming the correct needle position with contrast medium, RF energy is delivered for 60–120 seconds; patients can then be mobilized and discharged within a few hours. Common complications are rare and generally limited to temporary needle site pain, transient numbness, or low risks of infection and bleeding; the likelihood of permanent nerve damage is very low.

Epidural Injection (Targeted Shot)

In herniated disc treatment, an “epidural injection,” also known as a “targeted shot,” is the administration of a mixture of steroid + local anesthetic (and hyaluronidase if needed) into the epidural space surrounding the nerve root, using a thin needle guided by fluoroscopy or ultrasound. These medications rapidly reduce the edema and inflammation caused by the herniation, thereby alleviating nerve compression, and thus can provide significant relief from leg or back pain within days.

The procedure takes 10-15 minutes under local anesthesia, and patients are generally discharged walking after a few hours of observation; side effects are limited to temporary pain at the injection site, and rarely, infection or bleeding risk. To ensure lasting effectiveness, 2-3 sessions can be applied within a year if necessary, and subsequent exercise, weight control, and ergonomic habits support the success of the treatment.

Epiduroscopy

Epiduroscopy is an endoscopic procedure used in herniated disc treatment, where a thin, lighted fiber optic camera and catheter system are advanced into the epidural space via the sacral hiatus (natural opening in the tailbone). The physician directly visualizes the herniated disc tissue, adhesions, and inflammatory areas around the nerve root on a screen; if necessary, adhesions can be mechanically separated, tissue can be shrunk with a laser / radiofrequency probe, and medications containing steroids or enzymes can be delivered precisely to the target site as a “targeted shot.”

This minimally invasive procedure, lasting 30-60 minutes under local or mild sedation, offers less tissue trauma, same-day discharge, and a faster return to daily life compared to classic surgery. Possible risks include temporary pain at the needle entry site, a low rate of infection, and rarely, nerve irritation; pre-procedure MRI evaluation and selecting an experienced team enhance safety.

Ozone Therapy

Ozone therapy is a minimally invasive and fast-recovering non-surgical treatment option for herniated discs, aiming to alleviate nerve compression by reducing disc volume and localized inflammation.

It is applied to individuals with an intact outer disc on MRI, moderate nerve compression, and those who are not suitable for surgery or do not wish to undergo surgery.

Laser Discectomy

Laser discectomy for a herniated disc is a procedure that involves inserting a thin needle-catheter into the disc and vaporizing a portion of the jelly-like nucleus with a laser fiber to reduce internal pressure. It is performed under fluoroscopy or endoscopy guidance; the heat energy shrinks the disc protrusion, and the pressure on the nerve root and inflammatory edema decrease. It usually takes 15-30 minutes under local anesthesia, requires no tissue incision or stitches; the patient can be discharged walking after a few hours of observation.

Stem Cell Application

In stem cell therapy, stem cells obtained from the patient’s own bone marrow or a donor are injected into the herniated disc with a fine needle under fluoroscopy or CT guidance after a special centrifugation-separation process. The procedure usually takes 30 minutes under local anesthesia, and most patients can be discharged on the same day. This provides a direct “biological repair” signal to the disc without open surgical incision.

Stem cells aim to repair proteoglycan loss in the degenerative disc, increase collagen synthesis, and reduce nerve root edema by releasing anti-inflammatory cytokines. In laboratory and animal models, these cells have been shown to increase water retention capacity, partially preserve disc height, and suppress the inflammatory process that triggers pain.

Clinically, randomized controlled trials published between 2024–2025 have shown that it can provide ≥ 50% improvement in disability index and pain scores; more than 72% of patients reported clinically significant pain reduction at 52 weeks.

The procedure is applied in experienced centers with ethically approved protocols for selected patients without severe neurological loss, with significant preservation of disc height, and seeking an alternative to classic surgery.

Factors Influencing Treatment Choice

The level of herniation, disc structure, the patient’s general health, and previous treatment experiences are taken into consideration. The success of the treatment is enhanced by personalized physiotherapy and lifestyle adjustments.

Rehabilitation After Minimally Invasive Procedures

Rehabilitation after these procedures includes:

• Early mobilization (generally on the same day)
• Controlled stretching and core stability exercises
• Regular posture training and ergonomics
• Psychosocial support and stress management