Percutaneous laser disc decompression: a 17-year experience.

In this review, we analyze our effort to demonstrate the effectiveness of a new approach to the treatment of herniated disc disease using Nd:YAG laser energy introduced into a herniated disc under fluoroscopic control and local anesthesia. 2400 PLDD procedures (combined number of decompressions in cervical, thoracic, and lumbar discs were performed in the past 18(1/2) years in 1275 patients. The overall success rate according to the MacNab criteria was 89%. The complication rate (only infectious disciitis) was 0.4%; all 10 patients with complications were cured with appropriate antibiotics. The recurrence rate was 5%, and usually due to reinjury. There were no deaths, and no cases of nerve or cord damage. PLDD is a safe and effective outpatient procedure for the treatment of herniated disc disease with the advantages of relative non-invasiveness, usually immediate relief of back and sciatic pain, early return to work (generally 5-6 days), and a low complication and recurrence rate. It can also be repeated if necessary as many as five times.