Laser Disc Decompression Research Articles

Microendoscopic discectomy as a revision surgery after percutaneous laser disc decompression

Microendoscopic discectomy as a revision surgery after percutaneous laser disc decompression

Percutaneous Laser Disc Decompression: An Update

Photomedicine and Laser SurgeryVol. 22, No. 5 IntroductionPercutaneous Laser Disc Decompression: An UpdateDaniel S.J. ChoyDaniel S.J. ChoySearch for more papers by this authorPublished Online:18 Nov 2004https://doi.org/10.1089/pho.2004.22.393AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail FiguresReferencesRelatedDetailsCited byCT‐Guided Percutaneous Laser Disc Decompression for Lumbar Discogenic Radiculopathy‐Performance of a Novel Combi‐Therapy2 September 2019 | Lasers in Surgery and Medicine, Vol. 52, No. 5Efficacy Evaluation of Percutaneous Laser Disc Decompression in the Treatment of Lumbar Disc Herniation Longxi Ren, Han Guo, Tongtong Zhang, Zhengfeng Han, Linlin Zhang, and Yanjun Zeng8 April 2013 | Photomedicine and Laser Surgery, Vol. 31, No. 4High-Field Open MRI-Guided InterventionsIntradiscal temperature monitoring using double gradient-echo pulse sequences at 1.0T24 May 2010 | Journal of Magnetic Resonance Imaging, Vol. 31, No. 6Percutaneous endoscopic laser annuloplasty for discogenic low back painWorld Neurosurgery, Vol. 73, No. 3Il punto sulle metodiche mini-invasive12 December 2008 | Archivio di Ortopedia e Reumatologia, Vol. 119, No. 2Percutaneous Laser Disc Decompression for the Treatment of Lumbar Disc Herniation: A ReviewSeminars in Arthritis and Rheumatism, Vol. 37, No. 1Nonendoscopic Percutaneous Disc Decompression as Treatment of Discogenic Radiculopathy16 April 2013Lumbar Anular and Intradiskal Treatment for Degenerative Disk Disease: Anular RepairThe Biomechanics and Biology of the Spinal Degenerative CascadeSeminars in Spine Surgery, Vol. 17, No. 3Intradiscal TherapySpine, Vol. 30, No. SupplementLaser Literature Watch6 September 2005 | Photomedicine and Laser Surgery, Vol. 23, No. 4Laser Literature Watch14 June 2005 | Photomedicine and Laser Surgery, Vol. 23, No. 3Laser Literature Watch23 May 2005 | Photomedicine and Laser Surgery, Vol. 23, No. 2 Volume 22Issue 5Oct 2004 InformationCopyright 2004, Mary Ann Liebert, Inc.To cite this article:Daniel S.J. Choy.Percutaneous Laser Disc Decompression: An Update.Photomedicine and Laser Surgery.Oct 2004.393-406.http://doi.org/10.1089/pho.2004.22.393Published in Volume: 22 Issue 5: November 18, 2004PDF download

Risk Evaluation of Thermal Injury to the Cervical Spine during Intradiscal Laser Applicationin Vitro

We aimed to investigate temperature distribution during laser and its possible thermal damage to the neurovascular structures. Percutaneous laser disc decompression (PLDD) is now being performed as a minimally invasive intradiscal technique for the operative therapy of non-sequestered herniated cervical discs. As yet, no experimental basic research has been reported with regard to temperature rise and distribution in the cervical region during laser radiation. An in vitro laser procedure was performed on human cervical intervertebral discs under standardized conditions. A thermo-camera was used to monitor in real-time the zones sensitive to temperature increase. Average intervertebral disc volume was 2000 mm3. With a total energy conduction of 600 Joules, a temperature increase of around 30 degrees C was shown with an initial temperature of 28 degrees C at the posterior longitudinal ligament lying immediately in front of the myelon. The defect volume was less than 1% of the total intervertebral disc volume. If, during laser application, the total amount of conducted energy is too high, with an unfavorable position of the fibers in the intervertebral space, there is a risk of thermal damage to the spinal cord and nerve roots.

Preliminary Italian Experience of Lumbar Spine Percutaneous Laser Disc Decompression According to Choy's Method

The purpose of this paper is to describe the preliminary first Italian experience on lumbar spine percutaneous laser disc decompression (PLDD) using a Nd:YAG laser according to Choy's technique. PLDD is a minimally invasive technique for the treatment of a widely selected group of patients affected by herniated disc problems. Several studies, using a variety of different lasers used, have demonstrated its safety and worth. The current study is the first large PLDD series reported in Italy. Lumbar PLDD procedures, according to Choy's method, were performed in 92 patients. There were 53 male and 39 female patients, and their ages ranged from 21 to 79 years. All the patients were treated in the operative room according to aseptic rules. The overall results, evaluated with the MacNab criteria with a short follow-up (medium 5 months, maximum 12 months) were as follows: 76 patients (82.8%) showed excellent or good improvement, and 16 patients (17.2%) showed no or poor improvement. No complications were observed. These results, even though a longer follow-up is needed in future studies, have confirmed that PLDD (according to Choy's method) is a first-choice treatment for a large group of patients affected by herniated disc that is not responding to conservative treatment.

Principles of Lasers and Biophotonic Effects

In this review, we discuss how, due to a variety of different interactions between laser radiation and biological tissue, the laser has become an established instrument in most medical fields. Depending on the interaction time and the effective power density, three types of laser tissue interaction can be distinguished: photochemical effects, photothermal effects, and photomechanical and photoionizing effects. After a description of the physical mechanisms, the typical parameters, and the medical applications of these effects, a review of the laser types used in medicine is given. For percutaneous laser disc decompression (PLDD), lasers in the near-infrared region (Nd:YAG, Ho:YAG, and diode lasers) and with visible green radiation (frequency doubled Nd:YAG, called "KTP laser") were reported to be effective.

Complications of Non-endoscopic Percutaneous Laser Disc Decompression and Nucleotomy with the Neodymium: YAG Laser 1064 nm

In this review, we discuss how nonendoscopic percutaneous laser disc decompression (PLDD) and nucleotomy, using the YAG laser 1064, now has reinforced itself as a minimally invasive procedure in discogenic, vertebral pain syndromes, created by bulging, protrusions, and contained and uncontained extrusions in all areas of the spine. The rate of complication is an important criterion of the application of this new method. 3377 patients were treated with this method in the period of November 11, 1989 to April 30, 2002. While 356 patients' cervical spine was operated on, a further 38 patients had their thoracic spine operated on. Six weeks later, a prospective, consecutive control followed with an uninterrupted recording. Subsequently, all complications that occurred in this time frame were recorded. A comparison was carried out between the complication rate as covered by the literature of other intradiscal percutaneous methods and open disc surgery. Using the Nd-YAG laser 1064 nm, PLDD is generally evaluated with a complication rate of 0.5%. In the cervical spine area, the complication rate was 1.0%. No significant complications followed the thoracic intervention. In comparison to figures suggested by the relevant literature regarding possible complications with other procedures, this particular procedure is relative risk-free. In conjunction with the satisfying results regarding pain and paralysis removal, the extraordinarily low complication density of Nd-YAG PLDD culminates in the recommendation that the procedure should be applied to patients who are between unsuccessful conservative therapy and other operative methods.

Percutaneous Laser Disc Decompression in the Treatment of Discogenic Back Pain

Percutaneous Laser Disc Decompression in the Treatment of Discogenic Back Pain

Percutaneous Laser Disc Decompression for the Treatment of Discogenic Lumbar Pain and Sciatica: A Preliminary Report with 3-Month Follow-Up in a General Pain Clinic Population

Our aim was to evaluate the short-term efficacy of percutaneous laser disc decompression (PLDD) for the treatment of lumbar discogenic pain and sciatica. PLDD has been reported to be a safe, effective, minimally invasive treatment option for patients with lumbar spinal pain associated with herniated disc, as an alternative to open spinal surgery. The present study was designed to evaluate the effectiveness of the procedure in patients attending a comprehensive interventional pain management clinic. Thirty-two consecutive patients with discogenic lumbar spinal pain with or without sciatica were identified by MRI scanning and discography. Patients with symptoms attributable to a herniated or degenerated lumbar disc were treated with PLDD utilizing the neodymium-YAG laser. The primary endpoint of the study was the standardized symptom score on the American Academy of Orthopedic Surgery (AAOS) Outcomes Assessment Questionnaire for neurogenic and back pain symptoms at pre-treatment baseline, and at 3 months after laser treatment. Of the 30 patients with sciatica at baseline, 24 (80%) reported improvement in sciatica symptoms at three months, with a mean improvement of 68% (p = 0.001 from baseline values). Of the 32 patients with discogenic pain at baseline, 24 (75%) reported improvement at 3 months, with a mean improvement of 44% (p = 0.0005 from baseline values). No instances of infection, nerve injury, or clinically significant bleeding were identified during the 3-month follow-up period. Similar results were also seen in seven patients undergoing PLDD for residual back pain and sciatica following open spinal surgery. Sixty-three percent of patients complained of new-onset or worsening of mechanical low back pain following PLDD, thought to be related to the procedure. Back pain was considered mild to moderate and was self-limited, or responsive to analgesics and lumbar facet block with or without lumbar rhizotemy. PLDD with the neodymium-YAG laser is a safe and effective treatment for discogenic lumbar pain and sciatica during a preliminary 3-month follow-up period in a general pain management practice setting. Post-procedural mechanical low back pain is common and easily treated without sequellae. No instances of infection, neural injury, or other serious complications were observed.

Preliminary Italian Experience of Lumbar Spine Percutaneous Laser Disc Decompression According to Choy's Method

Objective: The purpose of this paper is to describe the preliminary first Italian experience on lumbar spine percutaneous laser disc decompression (PLDD) using a Nd:YAG laser according to Choy's technique. Background Data: PLDD is a minimally invasive technique for the treatment of a widely selected group of patients affected by herniated disc problems. Several studies, using a variety of different lasers used, have demonstrated its safety and worth. The current study is the first large PLDD series reported in Italy. Materials and Methods: Lumbar PLDD procedures, according to Choy's method, were performed in 92 patients. There were 53 male and 39 female patients, and their ages ranged from 21 to 79 years. All the patients were treated in the operative room according to aseptic rules. Results: The overall results, evaluated with the MacNab criteria with a short follow-up (medium 5 months, maximum 12 months) were as follows: 76 patients (82.8%) showed excellent or good improvement, and 16 patients (17.2%) showed no or poor improvement. No complications were observed. Conclusion: These results, even though a longer follow-up is needed in future studies, have confirmed that PLDD (according to Choy's method) is a first-choice treatment for a large group of patients affected by herniated disc that is not responding to conservative treatment.

Percutaneous Laser Disc Decompression in the Treatment of Discogenic Back Pain

Our aim was to evaluate the effects of percutaneous laser disc decompression (PLDD) as discogenic pain treatment using the MacNab criteria. Discogenic back pain is believed to be produced from tears in the posterior longitudinal ligament and annulus fibrosus. This pain is exacerbated through increases in intradiscal pressure via provocative discograms and transmitted through the sinuvertebral nerve. A total of 37 patients were selected based on clinical findings and provocative discograms. These patients underwent PLDD to the affected disc and were interviewed via telephone and outcome evaluated based on the MacNab criteria. Survey results revealed that 14 patients (44%) reported a good response, 14 (44%) reported a fair response, and four (12.5%) reported a poor response. The 28 patients (88%) who reported a good and fair response were considered to be successful cases. PLDD is a safe, effective, and minimally invasive procedure that can be used to treat patients with discogenic back pain.

Cervical Disc Herniations and Percutaneous Laser Disc Decompression: A Case Report

This is a report on 178 herniated cervical discs in 93 patients treated with percutaneous laser disc decompression (PLDD) using the Nd:YAG laser at the Laser Spine Center from November 1994 to October 2003. Patients with MRI documented disc herniations in the cervical spine who had failed conservative treatment and were sufficiently symptomatic to require surgical intervention were included in the study. A Seldinger needle was inserted under fluoroscopic guidance and local anesthesia into the offending cervical disc from an anterolateral approach until the tip was just beyond the annulus. Through an optical fiber connected to an Nd:YAG laser, 300 joules were delivered to the disc. A dressing was applied and the patient sent home, to return to work the following day. According to the MacNab criteria, 90% of the patients improved. All of them were permitted to return to work the following day. One complication (0.6%) occurred: a retro-esophageal abscess that responded to incision and drainage. PLDD of cervical disc herniations is effective and relatively non-invasive, and has a low complication rate. Because of the complexity of vital adjacent anatomic structures, it should only be performed after intensive training by a qualified interventionist with appropriate experience.

Percutaneous Laser Disc Decompression for the Treatment of Discogenic Lumbar Pain and Sciatica: A Preliminary Report with 3-Month Follow-Up in a General Pain Clinic Population

Objective: Our aim was to evaluate the short-term efficacy of percutaneous laser disc decompression (PLDD) for the treatment of lumbar discogenic pain and sciatica. Background Data: PLDD has been reported to be a safe, effective, minimally invasive treatment option for patients with lumbar spinal pain associated with herniated disc, as an alternative to open spinal surgery. The present study was designed to evaluate the effectiveness of the procedure in patients attending a comprehensive interventional pain management clinic. Materials and Methods: Thirty-two consecutive patients with discogenic lumbar spinal pain with or without sciatica were identified by MRI scanning and discography. Patients with symptoms attributable to a herniated or degenerated lumbar disc were treated with PLDD utilizing the neodymium-YAG laser. The primary endpoint of the study was the standardized symptom score on the American Academy of Orthopedic Surgery (AAOS) Outcomes Assessment Questionnaire for neurogenic and back pain symptoms at pre-treatment baseline, and at 3 months after laser treatment. Results: Of the 30 patients with sciatica at baseline, 24 (80%) reported improvement in sciatica symptoms at three months, with a mean improvement of 68% (p = 0.001 from baseline values). Of the 32 patients with discogenic pain at baseline, 24 (75%) reported improvement at 3 months, with a mean improvement of 44% (p = 0.0005 from baseline values). No instances of infection, nerve injury, or clinically significant bleeding were identified during the 3-month follow-up period. Similar results were also seen in seven patients undergoing PLDD for residual back pain and sciatica following open spinal surgery. Sixty-three percent of patients complained of new-onset or worsening of mechanical low back pain following PLDD, thought to be related to the procedure. Back pain was considered mild to moderate and was self-limited, or responsive to analgesics and lumbar facet block with or without lumbar rhizotemy. Conclusion: PLDD with the neodymium-YAG laser is a safe and effective treatment for discogenic lumbar pain and sciatica during a preliminary 3-month follow-up period in a general pain management practice setting. Post-procedural mechanical low back pain is common and easily treated without sequellae. No instances of infection, neural injury, or other serious complications were observed.

Cervical Disc Herniations and Percutaneous Laser Disc Decompression: A Case Report

Cervical Disc Herniations and Percutaneous Laser Disc Decompression: A Case Report

Principles of Lasers and Biophotonic Effects

In this review, we discuss how, due to a variety of different interactions between laser radiation and biological tissue, the laser has become an established instrument in most medical fields. Depending on the interaction time and the effective power density, three types of laser tissue interaction can be distinguished: photochemical effects, photothermal effects, and photomechanical and photoionizing effects. After a description of the physical mechanisms, the typical parameters, and the medical applications of these effects, a review of the laser types used in medicine is given. For percutaneous laser disc decompression (PLDD), lasers in the nearinfrared region (Nd:YAG, Ho:YAG, and diode lasers) and with visible green radiation (frequency doubled Nd:YAG, called "KTP laser") were reported to be effective.

Complications of Non-endoscopic Percutaneous Laser Disc Decompression and Nucleotomy with the Neodymium: YAG Laser 1064 nm

Complications of Non-endoscopic Percutaneous Laser Disc Decompression and Nucleotomy with the Neodymium: YAG Laser 1064 nm

Iatrogenic spondylodiscitis

Iatrogenic intervertebral disc space infection is encountered following microsurgical discectomy, percutaneous laser disc decompression, automated percutaneous lumbar nucleotomy operations, and discography. The purpose of this paper is to present a case report and review the literature on the uncommon origins of pyogenic spondylodiscitis and to emphasize the significance of prophylactic antibiotic therapy following transrectal ultrasonography-guided needle biopsy of the prostate (TUGNBP). According to the authors, this is the first reported case of pyogenic spondylodiscitis as a complication of TUGNBP in the English language literature.

Experiences of the revision surgery cases after laser disc decompression

Experiences of the revision surgery cases after laser disc decompression

Salvaged operation after percutaneous laser disc decompression for lumbar disc herniation

Salvaged operation after percutaneous laser disc decompression for lumbar disc herniation

Image-guided percutaneous laser disk decompression for herniated lumbar disks: a 4-year follow-up in 200 patients.

The purpose of this study was to describe the long-term effect of image-guided percutaneous laser disk decompression (PLDD). PLDD has been reported to be an alternative method to treat herniated lumbar disks. It has proved to be effective on a short-term basis. Although the procedure has been used for several years, few articles report on the long-term effect of the intervention. Two hundred patients, who were treated with image-guided PLDD for herniated lumbar disks, were observed over a period of 4 +/- 1.3 years. Treatments were carried out under CT/fluoroscopy guidance with local anesthesia on an outpatient basis with an Nd:YAG laser of 1064 nm. At follow-up, back pain was eliminated or reduced in 73% of the patients. Regarding sensorimotor impairment, PLDD did have a positive effect on 74% of the patients. In the majority of patients, the number of sick days and consumption of pain medication was reduced. In one patient, diskitis occurred as a complication of PLDD; 74% of the patients said they were satisfied with the outcome of the therapy; and 81.5% of the patients would have required another PLDD in cases of disk herniation. From our clinical results, we conclude that image-guided PLDD is an effective and secure method to treat contained herniated lumbar disks. Advantages of the procedure include the minimally invasive approach on an out-patient basis and the low complication rate.

Signal changes on MRI in the vertebral body adjacent to the disc receiving percutaneous laser disc decompression

Signal changes on MRI in the vertebral body adjacent to the disc receiving percutaneous laser disc decompression