title: Trans-Sacral Epiduroscopic Laser Decompression for Symptomatic Lumbar Disc Herniation: A Preliminary Case Series.
abstract: OBJECTIVE
  The purpose of this study was to investigate the effect of trans-sacral epiduroscopic laser decompression (SELD) in patients with a herniated lumbar disc.
  
  
  METHODS
  This prospective case series study was designed to determine the outcomes of SELD with regard to reducing pain and improving the functional status in patients with low back pain (LBP) and radiculopathy caused by definitive neural compression confirmed by MRI. A total of 250 patients with LBP and simultaneous radiculopathy underwent SELD by applying a Ho:YAG laser. Clinical outcomes were evaluated using the visual analogue scale (VAS) score for LBP, and radiculopathy and functional status were measured using the Oswestry Disability Index (ODI).
  
  
  RESULTS
  At 2 weeks after the procedure, the average VAS score for leg pain decreased to 3.6 from 7.1 (p < 0.01), and the average VAS score for back pain decreased to 4.1 from 5.9 (p < 0.01). At 3 months, the average VAS scores for leg and back pain decreased to 2.6 and 2.7, respectively. The mean ODI improved from 50 to 19 at 2 weeks postoperatively and further decreased to 12 at 3 months postoperatively.
  
  
  CONCLUSIONS
  The VAS score and ODI significantly improved after SELD in herniated nucleus pulposus (HNP) patients with LBP and radiculopathy. Postoperative MRI showed a notable decrease in the HNP size and a reduction in neural compression. SELD is suggested to be an effective therapeutic modality for patients with symptomatic HNP.
authors.affiliation: Department of Neurosurgery, Seoul Gimpo Airport Spine Health Wooridul Hospital , Seoul, Republic of Korea.
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, Seoul Gimpo Airport Spine Health Wooridul Hospital , Seoul, Republic of Korea.
authors.forename: Sang-Ho
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, Seoul Gimpo Airport Spine Health Wooridul Hospital , Seoul, Republic of Korea.
authors.forename: Kang Taek
authors.initials: KT
authors.lastname: Lim
mesh_terms: D019299:Decompression, Surgical / Q000379:methods*; D004724:Endoscopy; D004824:Epidural Space / Q000601:surgery*; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000601:surgery*; D017116:Low Back Pain / Q000209:etiology / Q000601:surgery; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011843:Radiculopathy / Q000209:etiology / Q000601:surgery; D012447:Sacrum / Q000601:surgery