Percutaneous Lumbar Laser Discectomy: Literature Review and a Retrospective Analysis of 65 Cases.

Abstract

Percutaneous lumbar laser discectomy is a minimally invasive treatment option for patients with a contained disc herniation with back and/or leg pain. The goal of this study was to present our experience and results with patients who underwent percutaneous lumbar laser discectomy in our practice. A total of 65 patients were included, and their charts were retrospectively reviewed. The most common level at which we performed the laser discectomy was the L5/S1 level 47.4% of the time. The next most common level was L4/L5 37.2% of the time and the least common level was L3/4 15.4% of the time. Neuritis was reported in four patients, which was treated with medication in two patients, and resolved in all four patients. The average preprocedure visual analog scale (VAS) score was 7.6/10 (range, 5-10/10). There was an improvement in the VAS score at 2-week follow-up. The average VAS score at 2-week follow-up was 3.7/10 (range, 0-10/10). The average VAS score at 6-week follow-up was 4.3/10 (range, 0-8/10). The average VAS score at 3-6 months was 4.1/10 [range, 0-8/10 and at 6-12 months was 4.2 (range, 0-8/10)]. Appropriate patient selection and following a systematic stepwise approach are important in treatment planning for patients in whom percutaneous laser discectomy is being considered. Following appropriate patient selection criteria maximizes the success rate of percutaneous laser discectomy. In our experience with patients with persistent back and/or leg pain not responding appropriately to conservative therapy, percutaneous laser discectomy offers a minimally invasive treatment option with nominal complications.