Results of a clinical trial of the holmium:YAG laser in disc decompression utilizing a side-firing fiber: a two-year follow-up.

BACKGROUND AND OBJECTIVE: Laser-assisted disc decompression (LADD) is an operative technique for the treatment of symptomatic, nonsequestered herniated nucleus pulposus that has failed to respond to conservative treatment. The current study reports 2-year follow-up data. STUDY DESIGN MATERIALS AND METHODS: Patients were evaluated by an independent interviewer postoperatively, and at 1 week, 3 months, 6 months, 1 year, and 2 years. Ratings were based upon the modified Macnab criteria. All patients evidenced primarily leg pain with or without back pain that had failed a minimum of 6 weeks of conservative treatment. Patients with lateral recess or central stenosis, sequestered discs, or predominantly scar tissue from a previous discectomy were not considered candidates for LADD.

RESULTS: Utilizing postoperative follow-up at 2 years, a surgical success rate of 86.9% was achieved. For patients requiring an additional LADD procedure, results at 6-month follow-up yielded a surgical success rate of 80%.

CONCLUSION: LADD appears to be a viable treatment modality for symptomatic, nonsequestered lumbar disc herniation recalcitrant to conservative treatment. LADD may represent a more cost-effective and safer alternative to traditional surgical procedures.