The PIDD Method

What the PIDD Method Is

Percutaneous Implant Disc Decompression

PIDD 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 (PODD), and hybrid laser treatment that combines laser and ozone methods for herniated discs, but unlike with PLDD or PODD, the volume of the intervertebral disc will not be reduced with PIDD 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 PIDD 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.

How the PIDD (Percutaneous Implant Disc Decompression) Method Is Done

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.

Treatable Conditions

  • Herniated Discs

Candidates Are People with These Kinds of Problems

  • 1

    Those suffering from low back pain caused by herniated discs

  • 2

    Those considering laser treatment (PLDD) for herniated discs

  • 3

    Those afraid of herniated disc surgery (like MED or PELD)

  • 4

    Those who have undergone herniated disc surgery but not improved (or whose condition has recurred)

  • 5

    Those who do not want to be hospitalized for herniated disc surgery for their low back pain and are therefore afraid of surgery

  • 6

    Those who are hoping for treatment that doesn’t take such a toll on the body

※We can also treat older people (80 years or above).

The Benefits of Doing the PIDD 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 PIDD 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.

The PIDD Method

The PIDD method is effective for herniated discs with especially high internal pressure that have not prolapsed from the ligaments and have mild to moderate herniation. The PIDD method is also an effective treatment in cases of prolapse or separation.

Pain caused by inflammation
Herniation retracts

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.

Treatment Time and Post-Treatment Issues

Treatment time
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. DST (Discseel™ treatment) 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.

Treatment Flow

  • InquiryInquiry


    We are an appointment-only clinic, so before you decide to visit us please call us to make an appointment. For further information or if you have any questions please do not hesitate to contact us.

  • Remote Image Diagnostic ServiceRemote Image Diagnostic Service

    Remote Image Diagnostic Service

    To ensure in that you are a good candidate for treatment at the clinic prior to your visit to Japan, you can forward us a recent MRI for our doctor to review and determine for free. If you are located nearby and you wish to undergo the MRI and X-ray scan at our clinic, you can call us to make an appointment.

  • Choose Operation DateChoose Operation Date

    Choose Operation Date

    If your diagnose confirms that your condition makes you a good candidate for treatment, you can proceed with scheduling the operation date.

  • Travel PreparationsTravel Preparations

    Travel Preparations

    Hospitalization is not required, so you will be discharged on the same day of the treatment. Obtaining a Japanese tourist visa will be enough, in case you are required to have one to enter the country. Patients are supposed to take care of their own visas, travel and accommodation arrangements.

  • Pre-treatment ConsultationPre-treatment Consultation

    Pre-treatment Consultation

    Upon arrival to the clinic the patient undergoes MRI and X-ray scan and an examination by the physician in charge, who according to the final diagnose determines the most suitable treatment option, followed by a detailed explanation.

  • TreatmentTreatment


    Treatment is conducted under local anesthesia, and it takes about 15-60 minutes, depending on the treatment method and number of treated discs.

  • Same-Day DischargeSame-Day Discharge

    Same-Day Discharge

    After resting for 1~2 hours and receiving a post-operative check by the operating physician, the patient is discharged and free to return home.

  • 8

    Post-treatment Follow-up

    We will contact you periodically to monitor your recovery progress. You should also feel free to contact us if you are unsure about anything.

Treatment Costs for the PIDD

Locations Treated 1 disc 2 discs 3 discs 4 discs 5 discs
Cost of Treatment 825,000 Japanese Yen (JPY) 935,000 Japanese Yen (JPY) 1,045,000 Japanese Yen (JPY) 1,155,000 Japanese Yen (JPY) 1,265,000 Japanese Yen (JPY)
*If the procedure is performed in our hospital, all the costs of consultation, diagnosis, MRI and other tests will be included in the costs listed above.
*If the same treatment is performed again within 3 years of the first treatment, the treatment fees will be reduced by half.
*All taxes included.
*Since this method of treatment is not covered by health insurance, the patient must bear the entire cost of the treatment.
*In case of treatment only (one day treatment), We accept payment by credit card (VISA, MasterCard, China UnionPay).
*If you wish to request rehabilitation (specialized for back pain), bank transfer by credit card is also accepted.
*You can receive a tax refund at the time of filing your tax return for medical expenses.

5 Types of Outpatient Treatment for Low Back Pain

  • The DST Method (Discseel™)

    An intervertebral disc treatment that began in the United States in the 2010s. Can be suitable for a wide range of conditions, including problems in patients after surgery. It is the only (※2)treatment that can repair and regenerate intervertebral discs.
    ※2 According to research by Operation Japan (Ltd.)

    Click here for details.
  • The PIDD Method (Implant)

    An implant intervertebral disc treatment that has been conducted since the 2000s. As with PLDD, results without injury to intervertebral discs can be anticipated. This treatment is suitable for herniated discs only.

    Click here for details.
  • Hybrid Laser Treatment

    A treatment that combines the benefits of PLDD and PODD. This treatment is suitable for herniated discs only.

    Click here for details.
  • The PODD Method (Ozone)

    An ozone intervertebral disc treatment that has been conducted mainly in Europe since the 1990s. It can be suitable for a wide range of conditions.

    Click here for details.
  • The PLDD Method (Laser)

    An outpatient, laser intervertebral disc treatment that has been well known worldwide since the 1980s. This treatment is suitable for herniated discs only.

    Click here for details.