Interventional radiology management of disc herniation: a narrative review.

Disc herniation (DH) is a common cause of spinal pain and radiculopathy. While most patients improve with conservative treatment, cases with persistent symptoms may require further intervention. In this context, interventional radiology (IR) offers image-guided, percutaneous techniques as a minimally invasive therapeutic option in the stepwise management of DH. This narrative review, conducted in accordance with SANRA principles, analyses the diagnostic and therapeutic role of IR in cervical, thoracic, and lumbar DH. A structured literature search was performed in PubMed/MEDLINE and Scopus to identify studies evaluating mechanical, thermal, chemical, and regenerative approaches. Reported outcomes included pain relief, functional recovery, complication rates, and need for reintervention. Evidence suggests that percutaneous intradiscal procedures may achieve meaningful short- and medium-term clinical improvement in carefully selected patients with contained herniations and clinicoradiological concordance. These techniques are associated with reduced invasiveness, shorter recovery times, and lower complication rates when performed by experienced practitioners. Imaging plays a central role in diagnosis, patient selection, procedural planning, as well as technical accuracy and safety. Nonetheless, current evidence remains heterogeneous and largely based on observational studies, with limited long-term comparative data. Further multicentre prospective trials and standardized outcome reporting are required to better define indications and lasting effectiveness.