J Korean Pain Soc.  2001 Dec;14(2):234-238.

Percutaneous Laser Discectomy in Lumbar Disc Herniation: A case report

Affiliations
  • 1Department of Anesthesiology, Yonsei University College of Medicine, Seoul, Korea. wokim@yumc.yonsei.ac.kr

Abstract

Percutaneous laser discectomy has potential advantages over conservative therapy and classical open surgery as a minimally invasive procedure, although clinical experiences are limited. We experienced a patient treated with herniated lumbar discs using Nd: YAG laser. A 55-year-old woman complained of severe back pain with sciatica on L4/5 and L5/S1 dermatome for several months. The MRI finding showed bulging discs at L4/5 and L5/S1. Epidural, transsacral and root block treatments were attempted without effect. Under fluoroscopic guidance, a 14 G biopsy needle was inserted into the L4/5 and L5/S1 disc spaces to the margin of the nucleus pulposus. Laser irradiation for vaporization of tissue was performed at 20 W/second to 1200 J. A laser fiber (600nm) was advanced 1 cm from the tip of the needle. At the end of the procedure, the patient began to feel relief of pain (VAS changed from 9 to 4) and was discharged the same day after staying 2 hours in the recovery room. Antibiotics were administered for prevention of discitis. She had no complaints of pain until the 1-month follow up visit. Percutaneous laser discetomy technique has the disadvantages of expensive equipment, high temperature and amount of vaporing disc tissue is empirical. However, this technique, as one of the therapeutic modalities for disc herniation, provides faster relief from acute attack than conservative management techniques in carefully selected patients with sciatica due to disc prolapse.

Keyword

Herniated intervertetebral disc; Percutaneous laser discectomy

MeSH Terms

Anti-Bacterial Agents
Back Pain
Biopsy
Discitis
Diskectomy*
Female
Follow-Up Studies
Humans
Lasers, Solid-State
Magnetic Resonance Imaging
Middle Aged
Needles
Prolapse
Recovery Room
Sciatica
Volatilization
Anti-Bacterial Agents
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