Abstract
Background: Laser discectomy or laser nucleotomy comprises an increasingly important place in less invasive spinal procedures, but the ideal laser is still a subject of study. This research was aimed to compare the action of diode laser at different wavelengths, as well as the volume of the vaporization lesion caused by the different wavelengths in the percutaneous decompression procedures of the intervertebral disc (nucleotomy). Methods: Six pigs' lumbar columns had their intervertebral discs (region L1 to L5) underwent punctureinduced injury. The columns were then subjected to the nuclear magnetic resonance (MR) for pre-irradiation analysis. Later, the discs were irradiated with a laser at the wavelengths of 808 nm (G808), 980 nm (G980), 1470 nm (G1470) and 1908 nm (G1908), or not irradiated (Control group). The columns were then destined for MR and then immersed in 10% buffered formalin for histological analysis. After being decalcified the intervertebral discs were dissected and processed for paraffin embedding. Transverse sections of the disks were stained with hematoxylin and eosin for histomorphometry and carbonized and bubble areas were measured. Results: The lesions were equivalent within each group and there was no difference between the groups in the pre-irradiation. In the post-irradiation evaluation, the MR showed that the volume of the intervertebral disc lesion was smaller in the G1470 and G1908 groups compared to the other groups. The G808 and G980 groups showed a higher thickness of carbonized area compared to groups G1470 and G1908. In addition, G980 presented higher thickness bubble area compared to the other groups. These lesions were more pronounced and more localized in the G808 and G980 groups, compared the 1470 nm and 1908 nm lasers, which caused broader but less intense lesions. Conclusion: The intervertebral disc lesions caused by the 808 nm and 980 nm laser are more intense but more focal, compared to the 1470 nm and 1908 nm laser.
Highlights
The most widely used method to correct herniated discs still consists in its withdrawal and in the settlement of the involved vertebrae through a procedure called arthrodesis, to prevent intervertebral space collapse [1]
The analysis of the images captured by magnetic resonance (MR) showed lesions of the discs, which varied in shape and extension according to the different wavelengths used
All discs were kept in 10% buffered formalin until their preparation for the microscopic examination to assess the changes generated by the different laser wavelengths
Summary
The most widely used method to correct herniated discs still consists in its withdrawal and in the settlement of the involved vertebrae through a procedure called arthrodesis, to prevent intervertebral space collapse [1]. Other less aggressive methods, such as percutaneous interventions, improve the results These procedures can be done through the application of high frequency (HF) or laser irradiation [2]. This research was aimed to compare the action of diode laser at different wavelengths, as well as the volume of the vaporization lesion caused by the different wavelengths in the percutaneous decompression procedures of the intervertebral disc (nucleotomy). G980 presented higher thickness bubble area compared to the other groups. These lesions were more pronounced and more localized in the G808 and G980 groups, compared the 1470 nm and 1908 nm lasers, which caused broader but less intense lesions.
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