Percutaneous laser diskectomy. An alternative method.

1. The percutaneous posterior approach with laser to a herniated lumbar intervertebral disc--heralded as a "minimal invasion" treatment for the symptomatic relief of discogenic back pain and sciatica--is an alternative method for the treatment of protrusion of a lumbar disc and its associated radiculopathy. 2. Percutaneous diskectomy is considered in patients who have unremitting radiculopathy with a contained disc herniation. The particular criteria for patient selection includes: evaluation of the patient's pain, performance status, medication dependence, and duration of symptoms. The patient must have demonstrable neurological impairment, positive nerve root tension signs, and correlative findings on imaging studies. 3. Percutaneous laser diskectomy has multiple advantages: it is an outpatient procedure performed under local anesthetic; it is less traumatic than open diskectomy; there is no epidural fibrosis; and there is a quick functional recovery with minimal pain and few complications.