Image-guided percutaneous laser disk decompression for herniated lumbar disks: a 4-year follow-up in 200 patients.
OBJECTIVE
The purpose of this study was to describe the long-term effect of image-guided percutaneous laser disk decompression (PLDD).


BACKGROUND
PLDD has been reported to be an alternative method to treat herniated lumbar disks. It has proved to be effective on a short-term basis. Although the procedure has been used for several years, few articles report on the long-term effect of the intervention.


METHODS
Two hundred patients, who were treated with image-guided PLDD for herniated lumbar disks, were observed over a period of 4 +/- 1.3 years. Treatments were carried out under CT/fluoroscopy guidance with local anesthesia on an outpatient basis with an Nd:YAG laser of 1064 nm.


RESULTS
At follow-up, back pain was eliminated or reduced in 73% of the patients. Regarding sensorimotor impairment, PLDD did have a positive effect on 74% of the patients. In the majority of patients, the number of sick days and consumption of pain medication was reduced. In one patient, diskitis occurred as a complication of PLDD; 74% of the patients said they were satisfied with the outcome of the therapy; and 81.5% of the patients would have required another PLDD in cases of disk herniation.


CONCLUSIONS
From our clinical results, we conclude that image-guided PLDD is an effective and secure method to treat contained herniated lumbar disks. Advantages of the procedure include the minimally invasive approach on an out-patient basis and the low complication rate.
Grönemeyer
D H W
DH
Grönemeyer Institute of MicroTherapy, Department of Radiology and Microtherapy, University of Witten/Herdecke, Bochum, Germany.
Buschkamp
H
H
Braun
M
M
Schirp
S
S
Weinsheimer
P A
PA
Gevargez
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical; D017587:Diskectomy, Percutaneous; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000601:surgery*; D053685:Laser Therapy / Q000379:methods; D017116:Low Back Pain / Q000209:etiology; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000209:etiology; D025321:Surgery, Computer-Assisted / Q000379:methods; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome