Role of Percutaneous Laser Disc Decompression in Patients with Lumbar Disc Herniation on Pain Relief: A Quasi-Experimental Pilot Study
DOI:
https://doi.org/10.31661/gmj.v11i.2382Keywords:
Lumbar Disc Herniation, Pain, Percutaneous Laser Disc DecompressionAbstract
Background: Disc herniation is broadly deï¬ned as a localized or focal displacement of disc material beyond the limits of the intervertebral disc space. The disc material may be the nucleus, cartilage, fragmented apophyseal bone, annular tissue, or any combination thereof. Laser surgery is one of the treatment modalities for treating patients with lumbar disc herniation. This study aims to examine the effect of Percutaneous Laser Disc Decompression (PLDD) in patients with lumbar disc herniation. Materials and Methods: This study was conducted on 58 patients who underwent PLDD (optical fiber inserted through an 18G needle, 8 joules, and 8 watts). Individuals were monitored before and after treatment using the comparing visual analog scale (VAS) pain score (from 0 [no pain] to 10 [severe pain]). Results: The mean age of participants was 63.19±13.48 years. Regarding gender, 24 patients (41.4%) were female. The mean VAS score before surgery was 8.73±1.29, and VAS score after surgery was 55.2±2.71, which means pain was significantly reduced (P<0.001). Conclusion: The patients’ post-PLDD pain may decrease; hence, PLDD can use as an appropriate method for treating lumbar disc herniation. [GMJ.2022;11:e2382]
References
Gilbert J, Wheeler G, Lingreen R, Martonffy D, Hatchett J, Gaines R, et al. The ten Cs of chronic noncancer pain: universal precautions for the chronic noncancer pain patient. Am J Pain Manage. 2005;15(1):22-32. Podichetty VK. The aging spine: the role of inflammatory mediators in intervertebral disc degeneration. Cellular and molecular biology (Noisy-le-Grand, France). 2007;53(5):4-18. Healthcare U. Physician guidelines: current evidence-based recommendations regarding imaging. Minneapolis: United Health Group. 2006. Borenstein DG, O'Mara JW, Boden SD, Lauerman WC, Jacobson A, Platenberg C, et al. The value of magnetic resonance imaging of the lumbar spine to predict low-back pain in asymptomatic subjects: a seven-year follow-up study. JBJS. 2001;83(9):1306-11. https://doi.org/10.2106/00004623-200109000-00002PMid:11568190 Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS. Magnetic resonance imaging of the lumbar spine in people without back pain. New England Journal of Medicine. 1994;331(2):69-73. https://doi.org/10.1056/NEJM199407143310201PMid:8208267 Stadnik TW, Lee RR, Coen HL, Neirynck E, Buisseret TS, Osteaux M. Annular tears and disk herniation: prevalence and contrast enhancement on MR images in the absence of low back pain or sciatica. Radiology. 1998;206(1):49-55. https://doi.org/10.1148/radiology.206.1.9423651PMid:9423651 WeiShaupt D, Zanetti M, Hodler J, Boos N. MR imaging of the lumbar spine: prevalence of intervertebral disk extrusion and sequestration, nerve root compression, end plate abnormalities, and osteoarthritis of the facet joints in asymptomatic volunteers. Radiology. 1998;209(3):661-6. https://doi.org/10.1148/radiology.209.3.9844656PMid:9844656 Gilbert JW, Martin JC, Wheeler GR, Storey BB, Mick GE, Richardson GB, et al. Lumbar disk protrusion rates of symptomatic patients using magnetic resonance imaging. Journal of manipulative and physiological therapeutics. 2010;33(8):626-9. https://doi.org/10.1016/j.jmpt.2010.08.010PMid:21036285 Frymoyer J. Lumbar disk disease: epidemiology. Instructional course lectures. 1992;41:217-23. Greenberg MS, Arredondo N. Handbook of neurosurgery. 2006. Hijikata S. Percutaneous discectomy: a new treatment method for lumbar disc herniation. J Tokyo Den-ryoku Hosp. 1975;5:39-44. Yucel A. Algologic approaches to the back pain. Turk J Phys Med Rehab. 1998;5:1-10. ErbaÅŸ YC, Pusat S, ErdoÄŸan E. Percutaneous laser disc decompression retrospective analysis of 197 cases and review of the literature. 2015. https://doi.org/10.5137/1019-5149.JTN.14692-15.2 Lee SH, Derby R, Sul Dg, Hong Jw, Kim GH, Kang S et al. Efficacy of a new navigable percutaneous disc decompression device (L'DISQ) in patients with herniated nucleus pulposus related to radicular pain. Pain Medicine. 2011;12(3):370-6. https://doi.org/10.1111/j.1526-4637.2011.01064.xPMid:21332936 Choy D, Case R, Fielding W, Hughes J, Liebler W. AscherP. Percutaneous laser nucleolysis of lumbar disks. N Engl J Med. 1987;317:771-2. https://doi.org/10.1056/NEJM198709173171217PMid:3627193 Schenk B, Brouwer PA, van Buchem MA. Experimental basis of percutaneous laser disc decompression (PLDD): a review of literature. Lasers in medical science. 2006;21(4):245-9. https://doi.org/10.1007/s10103-006-0393-yPMid:16937074 Schenk B, Brouwer P, Peul W, Van Buchem M. Percutaneous laser disk decompression: a review of the literature. American journal of neuroradiology. 2006;27(1):232-5. Yonezawa T, Onomura T, Kosaka R, Miyaji Y, Tanaka S, Watanabe H et al. The system and procedures of percutaneous intradiscal laser nucleotomy. Spine. 1990;15(11):1175-85. https://doi.org/10.1097/00007632-199011010-00017PMid:2267614 Choy D, Ascher PW, Ranu H, Saddekni S, Alkaitis D, Liebler W et al. Percutaneous laser disc decompression. A new therapeutic modality. Spine. 1992;17(8):949-56. https://doi.org/10.1097/00007632-199208000-00014PMid:1387977 Knight M, Goswami A. Lumbar percutaneous KTP532 wavelength laser disc decompression and disc ablation in the management of discogenic pain. Journal of clinical laser medicine & surgery. 2002;20(1):9-13. https://doi.org/10.1089/104454702753474940PMid:11902355 van den Akker-van Marle ME, Brouwer PA, Brand R, Koes B, van den Hout WB, van Buchem MA et al. Percutaneous laser disc decompression versus microdiscectomy for sciatica: Cost utility analysis alongside a randomized controlled trial. Interv Neuroradiol. 2017;23(5):538-45. https://doi.org/10.1177/1591019917710297PMid:28679342 PMCid:PMC5624405 Rahimzadeh P, Imani F, Ghahremani M, Faiz SHR. Comparison of percutaneous intradiscal ozone injection with laser disc decompression in discogenic low back pain. J Pain Res. 2018;11:1405-10. https://doi.org/10.2147/JPR.S164335PMid:30104895 PMCid:PMC6074825 Healing PLDDMIF, Wuhan Dimed Laser Technology Co. L. 28. Plapler H, Mancini MW, Sella VR, Bomfim FR. Evaluation of different laser wavelengths on ablation lesion and residual thermal injury in intervertebral discs of the lumbar spine. Lasers Med Sci. 2016;31(3):421-8. https://doi.org/10.1007/s10103-016-1865-3PMid:26796705 Schenk B, Brouwer PA, Peul WC, van Buchem MA. Percutaneous laser disk decompression: a review of the literature. AJNR Am J Neuroradiol. 2006;27(1):232-5. Gupta S, Gupta M, Nath S, Hess GM. Survey of European pain medicine practice. Pain Physician. 2012;15(6):983-94. https://doi.org/10.36076/ppj.2012/15/E983 Jacobs WC, van Tulder M, Arts M, Rubinstein SM, van Middelkoop M, Ostelo R et al. Surgery versus conservative management of sciatica due to a lumbar herniated disc: a systematic review. European Spine Journal. 2011;20(4):513-22. https://doi.org/10.1007/s00586-010-1603-7PMid:20949289 PMCid:PMC3065612 Dewing CB, Provencher MT, Riffenburgh RH, Kerr S, Manos RE. The outcomes of lumbar microdiscectomy in a young, active population: correlation by herniation type and level. Spine. 2008;33(1):33-8. https://doi.org/10.1097/BRS.0b013e31815e3a42PMid:18165746 Choy DS. Percutaneous laser disc decompression: a 17-year experience. Photomedicine and laser surgery. 2004;22(5):407-10. https://doi.org/10.1089/pho.2004.22.407PMid:15671713 Brouwer PA, Brand R, van den Akker-van Marle ME, Jacobs WC, Schenk B, van den Berg-Huijsmans AA et al. Percutaneous laser disc decompression versus conventional microdiscectomy for patients with sciatica: two-year results of a randomised controlled trial. Interventional Neuroradiology. 2017;23(3):313-24. https://doi.org/10.1177/1591019917699981PMid:28454511 PMCid:PMC5490869 Menchetti PPM, Bini W. Percutaneous treatment in lumbar disc herniation. Minimally Invasive Surgery of the Lumbar Spine. Springer; 2014.83-105. https://doi.org/10.1007/978-1-4471-5280-4_4 Kasch R, Mensel B, Schmidt F, Ruetten S, Barz T, Froehlich S et al. Disc volume reduction with percutaneous nucleoplasty in an animal model. PLoS ONE. 2012;7(11):e50211. https://doi.org/10.1371/journal.pone.0050211PMid:23209677 PMCid:PMC3507698 Black W, Fejos AS, Choy DS. Percutaneous laser disc decompression in the treatment of discogenic back pain. Photomedicine and laser surgery. 2004;22(5):431-3. https://doi.org/10.1089/pho.2004.22.431PMid:15671718 Duarte R, Costa J. Percutaneous laser disc decompression for lumbar discogenic radicular pain. RadiologÃa (English Edition). 2012;54(4):336-41. https://doi.org/10.1016/j.rxeng.2011.02.003 McMillan MR, Patterson PA, Parker V. Percutaneous laser disc decompression for the treatment of discogenic lumbar pain and sciatica: a preliminary report with 3-month follow-up in a general pain clinic population. Photomedicine and laser surgery. 2004;22(5):434-8. https://doi.org/10.1089/pho.2004.22.434PMid:15671719 Tassi GP. Comparison of results of 500 microdiscectomies and 500 percutaneous laser disc decompression procedures for lumbar disc herniation. Photomedicine and Laser Therapy. 2006;24(6):694-7. https://doi.org/10.1089/pho.2006.24.694PMid:17199468 Ong D, Chua NH, Vissers K. Percutaneous Disc Decompression for Lumbar Radicular Pain: A Review Article. Pain practice: the official journal of World Institute of Pain. 2016;16(1):111-26. https://doi.org/10.1111/papr.12250PMid:25354274 Choy DS. Response of extruded intervertebral herniated discs to percutaneous laser disc decompression. Journal of clinical laser medicine & surgery. 2001;19(1):15-20. https://doi.org/10.1089/104454701750066893PMid:11547813 Lee S-H, Kang HS. Percutaneous endoscopic laser annuloplasty for discogenic low back pain. World neurosurgery. 2010;73(3):198-206. https://doi.org/10.1016/j.surneu.2009.01.023PMid:20860958 Kim PS. Nucleoplasty. Techniques in Regional Anesthesia and Pain Management. 2004;8(1):46-52. https://doi.org/10.1016/j.trap.2003.11.009 Maksymowicz W, Barczewska M, Sobieraj A. Percutaneous laser lumbar disc decompression - mechanism of action, indications and contraindications. Ortopedia, traumatologia, rehabilitacja. 2004;6(3):314-8. Feng F, Xu Q, Yan F, Xie Y, Deng Z, Hu C, et al. Comparison of 7 Surgical Interventions for Lumbar Disc Herniation: A Network Meta-analysis. Pain Physician. 2017;20(6):863-71. https://doi.org/10.36076/ppj.20.5.E863 Grönemeyer DH, Buschkamp H, Braun M, Schirp S, Weinsheimer PA, Gevargez A. Image-guided percutaneous laser disk decompression for herniated lumbar disks: a 4-year follow-up in 200 patients. Journal of clinical laser medicine & surgery. 2003;21(3):131-8. https://doi.org/10.1089/104454703321895572PMid:12828847 CHOY DS. Percutaneous laser disc decompression (PLDD): twelve years' experience with 752 procedures in 518 patients. Journal of clinical laser medicine & surgery. 1998;16(6):325-31. https://doi.org/10.1089/clm.1998.16.325PMid:10204439 Momenzadeh S, Koosha A, Kazempoor Monfared M, Bairami J, Zali A, Ommi D, et al. The Effect of Percutaneous Laser Disc Decompression on Reducing Pain and Disability in Patients With Lumbar Disc Herniation. J Lasers Med Sci. 2019;10(1):29-32. https://doi.org/10.15171/jlms.2019.04PMid:31360365 PMCid:PMC6499585
