Puncture laser microdiskectomy: 20-year experience
Objective. Based on the analysis of 4600 observations, to clarify the indications for the PLM and to identify absolute contraindications.
Materials and methods. 4600 patients with protrusions and herniated discs of the cervical and lumbar spine by the PLM method were treated. The results were evaluated by the VAS and McNab scales.
Results. Unsuccessful results were obtained in 13% of patients. The analysis of the causes of unsatisfactory results demonstrated that the elderly patient, long-term history, significant dehydration of the disk and the large size of the hernia, although negatively affecting the outcome of the treatment, can not be an absolute counter-indication to PLM. On the contrary, spinal degenerative stenosis and signs of hernia sequestration should be considered as an absolute counter-indication to PLM.
Conclusions. PLM is an effective and minimally invasive method for treating protrusions and herniated discs. It is important to take into account all medical grounds and counter-indications for this procedure.
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