title: Percutaneous endoscopic laser discectomy.
abstract: BACKGROUND
  The aim of the present paper was to systematically review the literature on percutaneous endoscopic laser discectomy (PELD) with respect to the safety and efficacy of the procedure. Where possible the procedure was compared with open discectomy.
  
  
  METHODS
  Studies on PELD were identified using MEDLINE (1984 to December 1999), EMBASE (1974 to December 1999) and Current Contents (1993 to Week 1, 2000). A number of search terms were used: PELD; PLDD (percutaneous laser disc decompression); and laser and (spine or lumbar) and (disc* or disk*). The Cochrane Library was searched from 1966 to issue 4, 1999, using the search terms 'discectomy' or 'discotomy'. Live human studies of patients with lumbar disc prolapses for whom surgery was appropriate were included. Cadaver studies were also included. A surgeon and reviewer independently assessed the retrieved articles for their inclusion in the review.
  
  
  RESULTS
  Only 12 papers were identified that related to PELD. The level of evidence for safety and efficacy was low; there were no controlled, blinded or randomized studies. The highest level of evidence came from time series studies. No quantitative analysis could be undertaken for the present review.
  
  
  CONCLUSIONS
  Given the extremely low level of evidence available for this procedure it was recommended that the procedure be regarded as experimental until results are available from a controlled clinical trial, ideally with random allocation to an intervention and control group.
authors.affiliation: Australian Safety and Efficacy Register for New Interventional Procedures-Surgical, Royal Australasian College of Surgeons, North Adelaide, SA.
authors.forename: M
authors.initials: M
authors.lastname: Boult
authors.forename: R D
authors.initials: RD
authors.lastname: Fraser
authors.forename: N
authors.initials: N
authors.lastname: Jones
authors.forename: O
authors.initials: O
authors.lastname: Osti
authors.forename: P
authors.initials: P
authors.lastname: Dohrmann
authors.forename: P
authors.initials: P
authors.lastname: Donnelly
authors.forename: J
authors.initials: J
authors.lastname: Liddell
authors.forename: G J
authors.initials: GJ
authors.lastname: Maddern
mesh_terms: D002102:Cadaver; D017586:Diskectomy / Q000379:methods*; D004724:Endoscopy; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery; D053685:Laser Therapy / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D012449:Safety