Abstract
The classical microsurgical approach in the treatment of herniated nucleus pulposus (HNP) has been substituted over the years by endoscopical approach, in which it is possible to practice via endoscopy a laser thermo-discoplasty, and by percutaneous laser disc decompression and nucleotomy. Percutaneous laser disc decompression and nucleotomy have been performed worldwide in more than 40,000 cases of HNP. Because water is the major component of the intervertebral disc and in HNP pain is caused by disc protrusion pressing against the nerve root, a 980 nm Diode (Biolitec AG-Germany) laser introduced via a 21-G needle under X-ray or CT-scan guidance and local anesthesia, vaporizes a small amount of the nucleous pulposus shrinking the disc and relieving the pressure on the nerve root. A multicentric retrospective study with a mean follow-up of 6 years was performed on 900 patients suffering from relevant symptoms that had been therapy-resistant for 6 months on average before consulting our department. Evaluation included 585 (65%) males and 315 (35%) females. The average age of patients operated was 46 years (18–54). The success rate at a mean follow-up of 5 years (2–6 years) was about 70% with a very low complication rate.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Case R.B.C., Choy D.S., Altman P. (1985) Intervertebral disc pressure as a function of fluid volume infused. J Clin Laser Med Surg. 13, 143–147.
Choy D.S., Ascher P.W., Ranu H.S., Alkaitis D., Leibler W., Altman P. (1993) Percutaneous Laser Disc Decompression. A new terapeutic modality. Spine. 18(7), 939.
Asher P.W. (1986) Application of the laser in neurosurgery. Lasers Surg Med. 2, 91–97.
Kosaka R. (1996) Percutaneous laser nucleotomy for lumbar disc herniation. Preliminary report of early results and MRI findings. Orthop Sci. 1, 102–112.
Turgut A. (1996) Effect of Nd:YAG laser on experimental disc degeneration, Part 2. Histological and MRI findings. Acta Neurochir. 138, 1355–1361.
Brat H. (2003) Changes in disc herniation after CT-guided percutaneous laser disc decompression (MRI findings). Lasers Med Sci. 18, Suppl.
Tonami H., Yokota H., Nakagawa T., et al. (1997) Percutaneous laser discectomy: MRI findings within the first 24 hours after treatment and their relationship to clinical outcome. Clin Radiol. 52(12), 938–944.
Yonezawa T., Onomura T., et al. (1990) The system and procedures of percutaneous intradiscal laser nucleotomy. Spine. 15(11), 1175–1185.
Hellinger J. (2000) Introduce of diode laser (940nm) – PLDN. Mediziert. 335–358.
Nakai S., Naga K., Maehara K., Nishimoto S. (2003) Experimental study using Diode Laser in discs – the healing processes in discs and adiacent vertebrae after laser irradiation. Lasers Med Sci. 18.
Menchetti P.P.M., Bini W., Fontanella A., Longo L., Canero G. (2005) Experimental study on Diode 980nm Laser effect on human and specimen lumbar disc. Photomed Laser Surg. 10–15.
Knight M., Goswami A. (2002) Lumbar percutaneous KTP532 wavelength laser disc decompression and disc ablation in management of discogenic pain. J Clin Laser Med Surg. 20(1), 9–13.
Menchetti P.P.M., Longo L. (2003) Percutaneous diode laser disc nucleoplasty. Lasers Med Sci. 18(Suppl 2), S1–S29.
Menchetti P.P.M., Longo L. (2003) Percutaneous diode laser disc nucleoplasty. Laser Florence 2003. Proceedings, ISBN 16057422. Vol. 5610. SPIE Publisher, Bellingham.
Conflict of interest statement I declare that I have no conflict of interest..
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer-Verlag/Wien
About this chapter
Cite this chapter
Menchetti, P.P.M., Canero, G., Bini, W. (2011). Percutaneous Laser Discectomy: Experience and Long Term Follow-Up. In: Alexandre, A., Masini, M., Menchetti, P. (eds) Advances in Minimally Invasive Surgery and Therapy for Spine and Nerves. Acta Neurochirurgica Supplementum, vol 108. Springer, Vienna. https://doi.org/10.1007/978-3-211-99370-5_18
Download citation
DOI: https://doi.org/10.1007/978-3-211-99370-5_18
Published:
Publisher Name: Springer, Vienna
Print ISBN: 978-3-211-99369-9
Online ISBN: 978-3-211-99370-5
eBook Packages: MedicineMedicine (R0)