• Logo
  • SBMUJournals

The Effect of Percutaneous Laser Disc Decompression on Reducing Pain and Disability in Patients With Lumbar Disc Herniation

Sirous Momenzadeh, Alireza Koosha, Morteza Kazempoor Monfared, Jafar Bairami, Alireza Zali, Davood Ommi, Behnam Hosseini, Masoud Hashemi, Shahram Sayadi, Reza Aryani, Fatemeh Nematollahi, Leila Nematollahi, Maryam Barati
230

Views


Abstract

Introduction: As low back pain incidence is increasing, noninvasive modalities are gaining attention for their ability to achieve the best possible outcome with the least complications. Percutaneous laser disc decompression (PLDD) is currently popular for this purpose. This study aims to evaluate the effect of PLDD on disability and pain reduction in patients with lumbar disc herniation.
Methods: Thirty patients were enrolled in this study. Spinal nerve blocks were conducted by laser discectomy single stage injection of a needle into the disc space. The nucleus pulposus of herniated discs were irradiated with laser in order to vaporize a small part of the nucleus pulposus of the intervertebral discs and reduce the voluminosity of diseased discs. Patients were treated with 1000 J of 980 nm diode laser with 5 W energy. In order to measure the severity of pain, visual analog scale (VAS) and also ODI (Oswestry Disability Index) were used. Data were analyzed using SPSS version 12.
Results: Thirty patients participated in this trial including 11 men and 19 women with a mean age (SD) of 40.8 (10.8) years. The mean patients VAS score and ODI level before and after discectomy showed statistically significant differences. The mean VAS and ODI scores showed no statistical difference between males and females (P < 0.05) and percutaneous laser discectomy decreased the VAS and ODI at both groups of patients similarly.
Conclusion: We found the use of PLDD reduces pain and disability in patients as a noninvasive procedure.

Keywords

Percutaneous laser disc decompression; Disability; Lumbar disc herniation.

References

Manchikanti L, Singh V, Falco FJ, Benyamin RM, Hirsch JA. Epidemiology of low back pain in adults. Neuromodulation. 2014;17 Suppl 2:3-10. doi: 10.1111/ner.12018.

Brouwer PA, Peul WC, Brand R, et al. Effectiveness of percutaneous laser disc decompression versus conventional open discectomy in the treatment of lumbar disc herniation; design of a prospective randomized controlled trial. BMC Musculoskelet Disord. 2009;10:49. doi: 10.1186/1471-2474-10-49.

Choy DS, Ascher PW, Ranu HS, et al. Percutaneous laser disc decompression, a new therapeutic modality. Spine (Phila Pa 1976). 1992;17(8):949-956.

Goupille P, Mulleman D, Mammou S, Griffoul I, Valat JP. Percutaneous laser disc decompression for the treatment of lumbar disc herniation: a review. Semin Arthritis Rheum. 2007;37(1):20-30.

Choy DS, Case RB, Fielding W, Hughes J, Liebler W, Ascher P. Percutaneous laser nucleolysis of lumbar disks. N Engl J Med. 1987;317(12):771-2.

Schenk B, Brouwer PA, van Buchem MA. Experimental basis of percutaneous laser disc decompression (PLDD): a review of literature. Lasers Med Sci. 2006; 21(4):245-249. doi:10.1007/s10103-006-0393-y

Choy DS, Michelsen J, Getrajdman G, Diwan S. Percutaneous laser disc decompression: an update--Spring 1992. J Clin Laser Med Surg. 1992;10(3):177–84.

Chiarotto A, Maxwell LJ, Terwee CB, Wells GA, Tugwell P, Ostelo RW. Roland-Morris Disability Questionnaire and Oswestry Disability Index: which has better measurement properties for measuring physical functioning in nonspecific low back pain? Systematic review and meta-analysis. Phys Ther. 2016;96(10):1620-1637. doi:10.2522/ ptj.20150420

Choi JY, Tanenbaum BS, Milner TE, et al. Thermal, mechanical, optical, and morphologic changes in bovine nucleus pulposus induced by Nd: YAG (lambda = 1.32 microm) laser irradiation. Lasers Surg Med. 2001;28(3):248-54.

Castro WH, Halm H, Jerosch J, Schilgen M, Winkelmann W. [Changes in the lumbar intervertebral disk following use of the Holmium-Yag laser--a biomechanical study]. Z Orthop Ihre Grenzgeb. 1993;131(6):610-614.

Dewing CB, Provencher MT, Riffenburgh RH, Kerr S, Manos RE. The outcomes of lumbar microdiscectomy in a young, active population: Correlation by herniation type and level. Spine (Phila Pa 1976). 2008;33(1):33-38. doi:10.1097/BRS.0b013e31815e3a42.

Choy DS. Percutaneous laser disc decompression: a 17- year experience. Photomed Laser Surg. 2004;22(5):407-410.

Kamper SJ, Ostelo RW, Rubinstein SM, et al. Minimally invasive surgery for lumbar disc herniation: a systematic review and meta-analysis. Eur Spine J. 2014;23(5):1021- 1043.

Savitz MH. Samer-day microsurgical artheroscopic lateral-approach laser- assisted (SMALL) fluoroscopic discectomy. J Neurosurg. 1994; 80(6):1039-45.

Kobayashi S, Shizu N, Suzuki Y, Asai T, Yoshizawa H. Changes in nerve root motion and intra-radicular blood flow during an intraoperative straight-leg-raising test. Spine (Phila Pa 1976). 2003;28(13):1427-34.

Mayer HM, Brock M, Berlien HP, Weber B. Percutaneous endoscopic laser discectomy (PELD). A new surgical technique for non- sequestrated lumber discs. Acta Neurochir Suppl (Wien). 1992; 54:53-8.

Gasper GD, Mullins LL, Hartman VL. Laser- assisted disc decompression: A clinical trial of the Ho:YAG laser with side- firing fiber. J Clin Laser Med Surg. 1995;13(1):27-32.

Casper GD, Hartman VL, Mullins LL. Results of a clinical trial of the Ho:YAG laser in disc decompression utilizing a side- firing fiber: A two-year follow-up. Lasers Surg Med. 1996;19(1):90-6.

Choy DS. Response of extruded intervertebral herniated discs to percutaneous laser disc decompression. J Clin Laser Med Surg. 2001; 19(1):15-20.

Zhao DQ, Du F, Yang J, Zheng YB. Cohort-controlled study on percutaneous laser decompression in treating lumbar disc herniation. Chin J Clin. Rehabil. 2005;9:202-203.




DOI: https://doi.org/10.22037/jlms.v10i1.17558