Experimental basis of percutaneous laser disc decompression (PLDD): a review of literature

Abstract

Percutaneous laser disc decompression (PLDD) is one of the so-called “minimally invasive” treatment modalities for lumbar disc herniation. The treatment is performed percutaneously; therefore, morbidity and convalescence period are postulated to be less than for conventional surgery. Because of the minimally invasive nature and the fact that return to work is usually possible within a few days after treatment, PLDD appears to be an interesting alternative to conventional surgery. However, PLDD still encounters a considerable amount of skepticism. Opponents usually dismiss PLDD as being an experimental treatment with unproven efficacy, while those advocating the use of PLDD tend to present it as some kind of miracle treatment. While well-designed clinical trials focusing primarily on the efficacy of PLDD are scarce [1], the amount of preclinical studies investigating the technical and biophysical aspects of PLDD has been growing steadily since its introduction in the late 1980s. By grouping the results of these preclinical trials, this review attempts to provide a comprehensive basis for further clinical research.