Percutaneous laser disc decompression for thoracic disc disease: report of 10 cases.
BACKGROUND
Discogenic pain or herniation causing neural impingement of the thoracic vertebrae is less common than that in the cervical or lumbar regions. Treatment of thoracic discogenic pain usually involves conservative measures. If this fails, conventional fusion or discectomy can be considered, but these procedures carry significant risk.


OBJECTIVE
To assess the efficacy and safety of percutaneous laser disc decompression (PLDD) for the treatment of thoracic disc disease.


METHODS
Ten patients with thoracic discogenic pain who were unresponsive to conservative intervention underwent the PLDD procedure. Thoracic pain was assessed using the Visual Analog Scale (VAS) scores preoperatively and at 6-month intervals with a minimum of 18-months follow-up. Patients were diagnosed and chosen for enrollment based on abnormal MRI findings and positive provocative discograms. Patients with gross herniations were not included.


RESULTS
Length of follow-up ranged from 18 to 31 months (mean: 24.2 mo). Median pretreatment thoracic VAS score was 8.5 (range: 5-10) and median VAS score at final follow-up was 3.8 (range: 0-9). Postoperative improvement was significant with a 99% confidence interval. Of interest, patients generally fell into two groups, those with significant pain reduction and those with little to no improvement. Although complications such as pneumothorax, discitis, or nerve damage were possible, no adverse events occurred during the procedures.


CONCLUSIONS
The study is limited by its small size and lack of a sham group. Larger controlled studies are warranted.


CONCLUSIONS
With further clinical evidence, PLDD could be considered a viable option with a low risk of complication for the treatment of thoracic discogenic pain that does not resolve with conservative treatment.
Haufe
Scott M W
SM
MicroSpine, DeFuniak Springs, FL 32435, USA. Haufe@MicroSpine.com
Mork
Anthony R
AR
Pyne
Morgan
M
Baker
Ryan A
RA
D000328:Adult; D000368:Aged; D019299:Decompression, Surgical; D017587:Diskectomy, Percutaneous / Q000379:methods*; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery*; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019616:Thoracic Surgical Procedures / Q000379:methods; D013904:Thoracic Vertebrae / Q000601:surgery*; D016896:Treatment Outcome