Percutaneous laser disc decompression. A new therapeutic modality.
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.
Choy
D S
DS
St. Luke's/Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, New York.
Ascher
P W
PW
Ranu
H S
HS
Saddekni
S
S
Alkaitis
D
D
Liebler
W
W
Hughes
J
J
Diwan
S
S
Altman
P
P
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