The PIDT Method (Implant)/ Treatment Overview
What the PIDT Method Is
Percutaneous Implant Disc Treatment
PIDT is a minimally invasive treatment for herniated discs used especially in Europe. It is a treatment in which the protruding intervertebral disc (its “nucleus pulposus,” or inner core) is restored and decompressed by injecting an implant gel into the disc. Our clinic also does laser treatment (PLDD), ozone treatment (PODT), and PLOT treatment that combines laser and ozone methods for herniated discs, but unlike with PLDD or PODT, the volume of the intervertebral disc will not be reduced with PIDT treatment. Since the injected material remains in the intervertebral disc as an implant after treatment, it functions as a buffer (or cushion) material, and preservation of intervertebral disc function can be anticipated. We therefore recommend PIDT over laser or ozone treatment. We particularly recommend this treatment to patients who are considering the risk of complications from conventional discectomy (such as MED or PELD) or other surgeries.
With the patient under local anesthesia, and while using an X-ray fluoroscope, we place a 0.8 mm (paracentesis) needle into the intervertebral disc and inject a therapeutic agent. For the protruding herniated disc, especially, the more the gel penetrates, the more effective it becomes.
- Disc Herniation
Who can be a candidate for the treatment?
- Those suffering from low back pain caused by herniated discs.
- Those considering laser treatment (PLDD) for herniated discs.
- Those afraid of herniated disc surgery (like MED or PELD).
- Those who have undergone herniated disc surgery but not improved (or whose condition has recurred).
- Those who do not want to be hospitalized for herniated disc surgery for their low back pain and are therefore afraid of surgery.
- Those who are hoping for treatment that doesn’t take such a toll on the body.
We can also treat elderly patients ( 80 years or above ).
The Benefits of Doing the PIDT Method
Improvement of Intervertebral Discs’ Buffer (Cushion) Function
Since the injected material remains in the intervertebral disc as an implant, it acts as the cushion function of an intervertebral disc does.
Outpatient Treatment That
The treatment takes about 30-40 minutes, and you will need to rest for around 60 minutes afterwards. You can go home in about 90 minutes.
A New Treatment to Replace Laser Treatment, Ozone Treatment, and Surgery
Treatment is possible even when laser treatment or surgery has been done without effect.
How Treatment Is Done and Treatable Conditions
The PIDT method is a treatment in which the protruding intervertebral disc (its “nucleus pulposus,” or inner core) is restored and decompressed by piercing the disc with a small needle and injecting a gel that then implants itself. This is a treatment using local anesthesia. The goal is to retain the intervertebral disc function while selectively eliminating or reducing the problematic herniation. Because the result is that gel is left in the intervertebral disc as an implant, the gel acts as the cushion function of an intervertebral disc does.
- Disc herniation causing inflammation of the compressed nerve.
- Using local anesthesia on the patient, we pierce the intervertebral disc with a small needle and inject a gel that implants itself.
- The protruding intervertebral disc is restored by decompression, and material that will function as a buffer (cushion) remains in the intervertebral disc as an implant after treatment.
Efficacy of the Method for Disc Herniation
The PIDT method is effective for herniated discs with especially high internal pressure that have not prolapsed from the ligaments and have mild to moderate herniation.
- approx. 30-40 minutes
You will need to rest for about 60 minutes after treatment, and you will need about 90 minutes until you can return home. Light activity can be done the following day, but you will need to postpone sports or heavy labor for around 7 days.
About Post-Treatment Issues
It is possible that your symptoms will temporarily worsen for 1-2 weeks after treatment. The reason is thought to be that surrounding tissue is pulled due to the decompression effect. In addition, treatment cannot be done if the intervertebral discs have been ground down. That is because there will be no space to inject the gel into the discs. The Discseel® Procedure is necessary in that kind of situation.
About Side Effects
There are no reports of nerve damage among our own cases or in articles. However, there is an extremely slight, but existent, possibility of an allergic reaction to the local anesthetic.
Physical Activity Guidelines After the Treatment
Since treatment is performed on an outpatient basis, patients can return to their daily life from the very next day after undergoing the procedure and are encouraged to walk and exercise as possible. However, it is advisable to temporarily refrain from the following exercises and daily activities.
|Exercises and daily life activities
that can be done after the treatment
|Period of restriction|
|Disposable body warmer||Same day|
|Pool Walking||3 days|
|Going to the gym||7 days|
|Nerve block procedure||7 days|
|Chiropractic adjustment||14 days|
|Sportbike riding||14 days|
* We recommend that you wait for at least 30 days before taking a golf round.
Treatment Costs for the PIDT Treatment
|Disc||1 disc||2 discs||3 discs||4 discs|
|Cost of Treatment||825,000(JPY)||935,000(JPY)||1,045,000(JPY)||1,155,000(JPY)|
*Consultation, diagnosis, MRI and other tests are all included in the treatment costs listed above.
*If the same treatment is performed again within 3 years after the first treatment, fees will be reduced by half.
*Since the treatment is not covered by the Japanese health insurance, the patient must bear the entire cost of the treatment.
*We accept payments by credit card (VISA, MasterCard, China UnionPay) and cash in Japanese Yen (JPY).
*All taxes included.
The PIDT Method: FAQ
Is it applicable for conditions other than disc herniation?
The PIDT treatment is designed to preserve the disc, so it cannot be performed if the disc has already collapsed. The reason for this is that there is no space for the gel to be injected into the disc. In such cases, the application of the Discseel® Procedure will be necessary.
How is it different from the PLDD method (laser treatment)?
The PLDD treatment makes disc herniation shrink by burning the intervertebral disc, but since its volume can not preserved, the possibility of recurrence is high. On the other hand the PIDT method not only preserves the intervertebral disc's height, but it also can be expected to have the effect of suppressing extrusion of the nucleus pulposus.
Will the gel leak out after the treatment?
Once the implant is injected, it quickly hardens and does not leak out.
How long after undergoing the treatment can I start exercising?
Patients are asked to refrain from strenuous exercise and heavy lifting for about a month. Light stretching and walking can be started about 2 weeks after the treatment.
Discseel® Procedure was developed by an American surgeon by the name of Dr. Kevin Pauza, after caring for hundreds of patients who were made worse following their spine surgery. The treatment aims to seal tears in herniated vertebral discs and help them regenerate and recover their, allowing permanent relief of back pain. Dr. Pauza holds a series of 16 patents for a device and Discseel® biologic that support the treatment. Dr.Nonaka has been licensed to perform the Discseel® Procedure in 2018, and more than 2,880 patient have undergone the treatment in our clinic since then. At present, approximately 20 doctors, including physicians from Harvard and Boston Universities are using the Discseel® Procedure to treat their patients in the USA. Dr. Nonaka is the first physician trained to perform the Discseel® Procedure in Japan.
The PIDT Method
Percutaneous Implant Disc
The PLOT Method
(Laser And Ozone)
Percutaneous Laser and Ozone Treatment
The PODT Method
Percutaneous Ozone Disc
The PLDD Method
Percutaneous Laser Disc
Spinal Canal Stenosis