Percutaneous Intradiscal Laser Discectomy

Abstract

Recently percutaneous discectomy, such as chemonucleolysis with chymopapain [1] and percutaneous nucleotomy with punch [2] or nucleotome, has been developed extensively in Europe and America to provide an alternative to surgery in the treatment of lumbar disc herniation. But percutaneous nucleotomy, as mentioned above, has not been used in our daily therapy because of the limitation of indication, complications and technical problems. The experimental study of percutaneous intradiscal laser discectomy (PILD) has been tried to provide an alternative to percutaneous discectomies which are currently applied. The protocol of our study was composed of five parts. The five parts were as follows: 1) The optimum condition was obtained to vaporizes nucleus pulposus with Nd: YAG laser using sacrificed rabbit and goat lumbar discs. 2) The intradiscal changes in the time course were observed by microscopic evaluation using rabbit lumbar discs. 3) The relationship between intradiscal pressure (IDP) and vertical load in the time course were compared between irradiated discs, normal discs and control discs which were operated by curette. 4) Fibers and needles were developed to diminish heat damage. 5) Preliminary in vivo trial of PILD was performed in anesthetized young goats under X-ray guidance prior to the application for human cases.