Percutaneous laser disc decompression in spinal stenosis.
OBJECTIVE
The authors determined whether percutaneous laser disc decompression (PLDD) is an effective treatment for spinal stenosis where bulging or protruding discs are a contributing factor.


BACKGROUND
Spinal stenosis is associated primarily with the middle-aged and elderly patients, its chief symptom being low back and/or radicular pain worsened by walking. The condition is particularly resistant to conservative measures and to open surgery. PLDD is a minimally invasive treatment for intervertebral disc protrusions with low morbidity and a high success rate.


METHODS
This unblinded study was undertaken to determine whether PLDD would alleviate the pain of spinal stenosis in patients who also had protruding lumbar discs. Thirty-five patients of both sexes and all ages with MRI-documented lumbar spinal stenosis associated with bulging or protruding discs were treated with PLDD on an outpatient basis. Pain relief was the only parameter followed. Patients were asked to rate their pain immediately after treatment, one day later, four weeks later, and at a follow-up ranging from five to forty-nine months later. Pain was quantified on a scale of 0-10, with 0 being a total absence of pain and 10 being severe pain. A score of 0-2 was considered excellent, 3-5 good, and 6-10 poor.


RESULTS
Excellent results were seen in 69% of cases, good in 9%, and poor in 22%. Pain relief immediately after treatment always continued through the four weeks and five to forty-nine-month follow-ups.


CONCLUSIONS
It was our conclusion that PLDD compares favorably with open surgery in the treatment of lumbar spinal stenosis that is partially or completely due to bulging or protruding discs.
Choy
D S
DS
Laser Spine Center, New York, NY, USA.
Ngeow
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical / Q000295:instrumentation; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000601:surgery*; D053685:Laser Therapy; D017116:Low Back Pain / Q000209:etiology / Q000601:surgery*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation; D010147:Pain Measurement; D013130:Spinal Stenosis / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome