The treatment is performed in the operating room and you will be sedated (no anesthesia). On the day of the treatment you should fast for at least 6 hours leading up to the treatment. This means that up to six hours before arriving you can have a cracker or biscuit without butter, and with just a little bit of sweet toppings for breakfast, and up to four hours before arriving you can only drink clear liquid drinks (water, tea, apple juice, or clear lemonade). Coffee is not allowed. You may take prescription medication with a sip of water. You’ll arrive at the clinic about an hour before the treatment. You will be escorted to your private room, where you can change into an operating gown. Before the procedure starts you will be picked up by a nurse and/or doctor who will walk with you to the treatment room. The treatment In the operating room the assistant anesthetist connects you to the monitoring equipment. You also get an IV in a vein in your arm. Through the IV you get a light sedative administered. The skin of the back is disinfected and covered with sterile drapes. After local sedation (5-10 ml lidocaine 2%) a special needle is inserted into the intervertebral disc on the uninvolved side with the help of X-ray. Afterwards a special catheter is inserted through this needle into the intervertebral disc. The temperature of the tip of the catheter is gradually increased. TDD procedure takes 12 minutes. It is possible that pain occurs in the back or leg. During the treatment, the doctor will ask if you feel any pain. As soon as the treatment protocol has been completed, the catheter and the needle are removed. After surgery you will be monitored for some time in the recovery room before being brought to your room.

After the treatment you will be taken back to your room where you can recover. You should stay in bed for at least an hour. You may lie on your side or stomach, but not get out of bed. The department nurse will help you and answer any questions you might have. After an hour of bed rest you can go home, unless something else is decided on consultation with the doctor. Since the treatment and anesthesia can affect your ability to react, you should not drive on the day of the surgery and the day after. You need to make sure someone else can bring you home. We will provide you with advisory precepts for the first few weeks after treatment. The next few days you may do what feels okay, but physical labor is not allowed in the beginning. Along the way you’ll notice that you can do more and more. Possible side effects During the TDD treatment the intervertebral disc is punctured on the uninvolved side to reach the damaged side by sliding over the catheter. This can lead to temporary pain in the back and/or the leg on the opposite side of where your original pain symptoms are located. After the you may experience post-operative pain, for example, a hematoma on the site of the treatment. This post-operative pain can linger for a few weeks, but eventually goes away on it’s own. You can take painkillers to help with the pain. This can be your own pain medication or paracetamol according to the dosage on the package leaflet. With each treatment there is a limited chance of infection. With the TDD treatment an infection of the intervertebral disc may occur. In order to prevent this, you will get antibiotics administered prior to treatment via the IV. If you develop a fever after the treatment, you should consult a doctor. Based on the cause of your pain, your specialist will assess if a physical treatment is necessary. Based on the medical history the necessity of additional tests will be decided.