Degenerative disease of the intervertebral discs (DDD) is currently a serious problem facing the world community. The surgical methods and conservative therapy used today, unfortunately, do not stop the pathological process, but serve as a palliative method that temporarily relieves pain and improves the patient’s quality of life. Therefore, at present, there is an active search for new methods of treating DDD. Among new techniques of treatment, biological methods, and minimally invasive surgery, including the use of laser radiation, which, depending on the laser parameters, can cause ablative or modifying effects on the disc tissue, have acquired considerable interest. Here, we analyze a new approach to solving the DDD problem: laser tissue modification. This review of publications is focused on the studies of the physicochemical foundations and clinical applications of a new method of laser reconstruction of intervertebral discs. Thermomechanical action of laser radiation modifies tissue and leads to its regeneration as well as to a long-term restoration of disc functions, elimination of pain and the return of patients to normal life.

The article presents morphometric MRI-analysis of the lumbar intervertebral foramen for anatomical study of the size of Kambin safety triangle and the vulnerability of the exiting spinal nerve during transforaminal interventions. 200 discs were studied in 50 patients after transforaminal endoscopic intervention. Standard DICOM image viewing program for MRI in T1 WI and T2 WI modes was used for the measurement. The most distant location of the exiting spinal nerve from the intervertebral disc was observed at the level of L5S1 vertebrae (9.82 mm, 0.95CI (9,53 10,10), p<0.05). The narrowest safety triangle turned out to be at the level of L2‑L5 vertebrae, where the distance did not differ statistically (1.97–2.28 mm, p> 0.05). A similar pattern was revealed for the distance between the exiting root and the intervertebral joint. The greatest angle between the exiting spinal nerve and the disc plane was found at the level of L5S1 (134.68 °, 0.95CI (132.39 136.97), p<0.001). The angle was close to a straight one at the other levels. The exiting root located dorsal to the disc plane at the cranial levels (L2L3, L3L4) in all cases, in contrast to L5S1 level, where it always located ventrally. Thus, the greatest narrowness of the Kambin safety triangle was revealed in the intervertebral foramen of the cranial lumbar segments (L2L3, L3L4). Transforaminal interventions require special attention to the exiting spinal nerve at these levels, and possibly additional bone resection to widen the foramen.