title: Percutaneous laser disc decompression. A new therapeutic modality.
abstract: The authors present a new advance in the treatment of herniated disc disease using percutaneous Nd:YAG laser to vaporize a small portion of nucleus pulposus, thereby decompressing the disc. In vitro and in vivo animal data are presented. Three hundred seventy-seven magnetic resonance imaging or computed tomography scan-documented, herniated, nonsequestered lumbar intervertebral discs with corresponding clinical findings in 333 patients were so treated in an outpatient setting. The longest follow-up was 62 months, with a mean of 26 months. According to the Macnab criteria, there was a good to fair response in 261 patients (78.4%), and a poor response in 72 (21.6%); 166 patients experienced relief of pain during the procedure. One-third of repeat magnetic resonance imaging scans at 4-6 months postlaser treatment showed modest to moderate decrease of disc herniation.
authors.affiliation: St. Luke's/Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, New York.
authors.forename: D S
authors.initials: DS
authors.lastname: Choy
authors.forename: P W
authors.initials: PW
authors.lastname: Ascher
authors.forename: H S
authors.initials: HS
authors.lastname: Ranu
authors.forename: S
authors.initials: S
authors.lastname: Saddekni
authors.forename: D
authors.initials: D
authors.lastname: Alkaitis
authors.forename: W
authors.initials: W
authors.lastname: Liebler
authors.forename: J
authors.initials: J
authors.lastname: Hughes
authors.forename: S
authors.initials: S
authors.lastname: Diwan
authors.forename: P
authors.initials: P
authors.lastname: Altman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001416:Back Pain / Q000209:etiology / Q000601:surgery; D004285:Dogs; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D053685:Laser Therapy / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011859:Radiography