Puncture laser microdiskectomy: 20-year experience

Authors

  • Mykola O. Zorin Dnipropetrovsk State Medical Academy, Dnipro; Mechnikov Dnipropetrovsk Regional Clinical Hospital, Dnipro; Medical Center «Endoscopic Neurosurgery», Dnipro, Ukraine
  • Tamara V. Zorina Dnipropetrovsk State Medical Academy, Dnipro; Mechnikov Dnipropetrovsk Regional Clinical Hospital, Dnipro; Medical Center «Endoscopic Neurosurgery», Dnipro, Ukraine
  • Mykola M. Zorin Dnipropetrovsk State Medical Academy, Dnipro; Mechnikov Dnipropetrovsk Regional Clinical Hospital, Dnipro; Medical Center «Endoscopic Neurosurgery», Dnipro, Ukraine

DOI:

https://doi.org/10.25305/unj.117768

Keywords:

disc protrusions, herniated discs, surgical treatment of protrusions and hernia, percutaneous methods, puncture laser microdiskectomy

Abstract

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.

References

1. Ascher PW, Heppner F. CO2-Laser in neurosurgery. Neurosurg Rev. 1984;7(2-3):123-33. [CrossRef] [PubMed]

2. Choy DS, Case RB, Fielding W, Hughes J, Liebler W, Ascher P. Percutaneous laser nucleolysis of lumbar disks. N Engl J Med. 1987 Sep 17;317(12):771-2. [CrossRef] [PubMed]

3. Choy DS. Percutaneous laser disc decompression: a 17-year experience. Photomed Laser Surg. 2004 Oct;22(5):407-10. [CrossRef] [PubMed]

4. Erbas YC, Pusat S, Erdogan E. Percutaneous Laser Disc Decompression: Retrospective Analysis of 197 Cases and Review of The Literature. Turk Neurosurg. 2015;25(5):766-70. [CrossRef] [PubMed]

5. Streitparth F, Walter T, Wonneberger U, Schnackenburg B, Philipp CM, Collettini F, Teichgrдber UK, Gebauer B. MR guidance and thermometry of percutaneous laser disc decompression in open MRI: an ex vivo study. Cardiovasc Intervent Radiol. 2014 Jun;37(3):777-83. [CrossRef] [PubMed]

6. Singh V, Manchikanti L, Calodney AK, Staats PS, Falco FJ, Caraway DL, Hirsch JA, Cohen SP. Percutaneous lumbar laser disc decompression: an update of current evidence. Pain Physician. 2013 Apr;16(2 Suppl):SE229-60. [PubMed]

7. Zhao XL, Fu ZJ, Xu YG, Zhao XJ, Song WG, Zheng H. Treatment of lumbar intervertebral disc herniation using C-arm fluoroscopy guided target percutaneous laser disc decompression. Photomed Laser Surg. 2012 Feb;30(2):92-5. [CrossRef] [PubMed] [PubMed Central]

8. Manchikanti L, Singh V, Falco FJ, Calodney AK, Onyewu O, Helm S 2nd, Benyamin RM, Hirsch JA. An updated review of automated percutaneous mechanical lumbar discectomy for the contained herniated lumbar disc. Pain Physician. 2013 Apr;16(2 Suppl):SE151-84. [PubMed]

9. Khyzhnyak MV, Priymake EV. [Puncture surgical technology in treatment of discogenic pain syndrome of the lumbar spine]. Ukrainian Neurosurgical Journal. 2013;(2):35-8. Russian. [CrossRef]

10. Pedachenko EG, Polishchuk ME, Slyn’ko EI, Khonda OM, Khyzhnyak MV. Diahnostyka ta khirurhichne likuvannya diskohennykh neyrokompresiynykh syndromiv khrebta. Kiev: TOV «VIK-PRYNT»; 2014. Ukrainian.

11. Khyzhnyak MV, Priymak EV. [Comparative assesstment of the immediate and remote results of puncture methods of treatment of discogenic pain syndromes of the lumbar spine in patients of different age groups]. International neurological journal. 2014;(1):121-6. Russian. [VernadskyNLU]

12. Pedachenko EG, Kramarenko VA, Krasilenko EP, Pedachenko YuE, Khizhnyak MV. [Pain syndromes of the early period after lumbar microdiscectomy]. International neurological journal. 2014;8(70):128-135. Russian. [VernadskyNLU]

13. Vasil’yev AYu, Kaznacheyev VM. Punktsionnaya lazernaya vaporizatsiya degenerirovannykh mezhpozvonkovykh diskov. Moscow: Ob’yedinennaya redaktsiya MVD RF; 2005. Russian.

14. Choy DS, Altman P, Trokel SL. Efficiency of disc ablation with lasers of various wavelengths. J Clin Laser Med Surg. 1995 Jun;13(3):153-6. [CrossRef] [PubMed]

15. Ren L, Guo H, Zhang T, Han Z, Zhang L, Zeng Y. Efficacy evaluation of percutaneous laser disc decompression in the treatment of lumbar disc herniation. Photomed Laser Surg. 2013 Apr;31(4):174-8. [CrossRef] [PubMed]

16. Casper GD, Mullins LL, Hartman VL. Laser-assisted disc decompression: a clinical trial of the holmium:YAG laser with side-firing fiber. J Clin Laser Med Surg. 1995 Feb;13(1):27-32. [CrossRef] [PubMed]

17. Brouwer PA, Brand R, van den Akker-van Marle ME, Jacobs WC, Schenk B, van den Berg-Huijsmans AA, Koes BW, van Buchem MA, Arts MP, Peul WC. Percutaneous laser disc decompression versus conventional microdiscectomy in sciatica: a randomized controlled trial. Spine J. 2015 May 1;15(5):857-65. [CrossRef] [PubMed]

Published

2018-03-16

How to Cite

Zorin, M. O., Zorina, T. V., & Zorin, M. M. (2018). Puncture laser microdiskectomy: 20-year experience. Ukrainian Neurosurgical Journal, (1), 60–65. https://doi.org/10.25305/unj.117768

Issue

Section

Original articles