Principle Of Percutaneous Laser Disc Decompression

Dorn Spinal Therapy

Spine Healing Therapy

Get Instant Access

The aim of PLDD is to vaporize a small portion of nucleus pulposus, thereby reducing the volume and pressure of the affected disc. The advantage of this percutaneous technique is the reduction of volume and pressure of the pathological disc without the damage of other spinal structures. In this procedure, the laser energy is transmitted through a thin optical fiber into the disc. The intact intervertebral disc can be compared to a closed hydraulic space surrounded by the annulus fibrosus and the end plates. The ablation of a relatively small volume of the nucleus results in an important reduction of intradiscal pressure, thus inducing reduction of disc herniation (11,14-17).

In the case of herniated intervertebral disc, the reduction of intervertebral disc pressure changes the gradient between the nucleus pulposus and the tissue surrounding the hernia-tion, with the result that the herniation tends to be "aspirated" back into the disc. After laser irradiation, intradiscal pressures decrease and the nucleus pulposus is gradually replaced by cartilaginous fibrous tissue (Fig. 1) (12). Therefore sequestrated disc fragment is a contraindication to PLDD. An experimental study has proven that during the PLDD, no temperature change is detected in the neural foramina and spinal canal (12). PLDD is a minimally invasive procedure available on an outpatient basis.

FIGURE 1 Diagram representing the percutaneous laser disc decompression technique. (A) The ablation of a relatively small volume of the nucleus results in an important reduction of intradiscal pressure. (B) Depending to the disc size, 1200 to 1500 J of energy is delivered to the nucleus. The vaporization is monitored by computed tomography scan. The fiber position can be modified during the procedure.

FIGURE 1 Diagram representing the percutaneous laser disc decompression technique. (A) The ablation of a relatively small volume of the nucleus results in an important reduction of intradiscal pressure. (B) Depending to the disc size, 1200 to 1500 J of energy is delivered to the nucleus. The vaporization is monitored by computed tomography scan. The fiber position can be modified during the procedure.

The reduction of intradiscal pressure does not seem to be the only effect of laser. Denervation of the annulus fibrosus and ligaments of the spinal column may be another. Heating the disc with the laser can lead to the destruction of nerve transmitter production sites (L-glutamate, substance P, peptides, and quinine).

Was this article helpful?

0 0
Dealing With Back Pain

Dealing With Back Pain

Deal With Your Pain, Lead A Wonderful Life An Live Like A 'Normal' Person. Before I really start telling you anything about me or finding out anything about you, I want you to know that I sympathize with you. Not only is it one of the most painful experiences to have backpain. Not only is it the number one excuse for employees not coming into work. But perhaps just as significantly, it is something that I suffered from for years.

Get My Free Ebook


Post a comment