Results of a clinical trial of the holmium:YAG laser in disc decompression utilizing a side-firing fiber: a two-year follow-up.
OBJECTIVE
Laser-assisted disc decompression (LADD) is an operative technique for the treatment of symptomatic, nonsequestered herniated nucleus pulposus that has failed to respond to conservative treatment. The current study reports 2-year follow-up data. STUDY DESIGN MATERIALS AND METHODS: Patients were evaluated by an independent interviewer postoperatively, and at 1 week, 3 months, 6 months, 1 year, and 2 years. Ratings were based upon the modified Macnab criteria. All patients evidenced primarily leg pain with or without back pain that had failed a minimum of 6 weeks of conservative treatment. Patients with lateral recess or central stenosis, sequestered discs, or predominantly scar tissue from a previous discectomy were not considered candidates for LADD.


RESULTS
Utilizing postoperative follow-up at 2 years, a surgical success rate of 86.9% was achieved. For patients requiring an additional LADD procedure, results at 6-month follow-up yielded a surgical success rate of 80%.


CONCLUSIONS
LADD appears to be a viable treatment modality for symptomatic, nonsequestered lumbar disc herniation recalcitrant to conservative treatment. LADD may represent a more cost-effective and safer alternative to traditional surgical procedures.
Casper
G D
GD
Laser Spine and Joint Center of the Southwest, Oklahoma City, Oklahoma 73109, USA.
Hartman
V L
VL
Mullins
L L
LL
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000538:Aluminum Silicates; D001416:Back Pain / Q000601:surgery; D003362:Cost-Benefit Analysis; D017586:Diskectomy / Q000191:economics / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006695:Holmium; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D053685:Laser Therapy / Q000191:economics / Q000295:instrumentation / Q000379:methods; D007866:Leg; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012449:Safety; D012585:Sciatica / Q000601:surgery; D016896:Treatment Outcome; D015019:Yttrium
D000538:Aluminum Silicates; D015019:Yttrium; D006695:Holmium