Percutaneous laser disc decompression for lumbar discogenic radicular pain

Objective: The aim of our study was to directly evaluate the effectiveness of percutaneous laser disc decompression (PLDD) for treatment of lumbar discogenic radicular pain.

Methods: From June 2006 through July 2009, 205 patients with contained disc herniation demonstrated on computed tomography (CT) or magnetic resonance, concordance between the radicular pain and the nerve root compressed by the herniated disc, neurological findings referring to a single nerve root and no improvement after conservative therapy for a minimum of six weeks were enrolled. All patients were treated with PLDD under CT guidance and local anaesthesia. Follow-up was scheduled at 1, 2 days, 3, 6 months. Subsequent follow-ups at 12, 24 and 36 months were carried out through visits or by telephone. Clinical outcome was quantified using the MacNab criteria.

Results: The age of patients ranged from 27 to 78 years (mean 58±11 years). The levels of involvement were 18 cases at L3-L4, 123 cases at L4-L5 and 64 cases at L5-S1. Using the MacNab criteria, the results were as follows: 67% (n=137) showed a good outcome and 9% (n=18) a fair outcome. There were no serious complications in our series.

Conclusions: PLDD is effective treatment for lumbar discogenic radicular pain, associated with only minimal discomfort to the patient. This minimally invasive technique is a valid alternative for those patients not responding to conservative medical treatment, allowing in many cases to obviate the need of spine surgery.