Impact of infrared laser light‐induced ablation at different wavelengths on bovine intervertebral disc ex vivo: Evaluation with magnetic resonance imaging and histology

Cselik, Zsolt; Aradi, Mihály; Jako, Ronald A. von; Lelovics, Zsuzsanna; Juhász, Ivett; Egyházi, Zsolt; Bogner, Péter; Romics, Imre; Schwarcz, Attila

doi:10.1002/lsm.22034

Cited by 12 publications

(10 citation statements)

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“…In another case report, a patient developed a subacute cauda equina syndrome after percutaneous lumbar laser disc decompression (228). In a 2012 publication by Cselik et al (147), the impact of infrared laser light-induced ablation at different wavelengths on bovine intervertebral discs ex vivo was evaluated by MRI and histology. They concluded that the 1470-nm laser light had an effect through the entire nucleus pulposus and not only at the site of the quartz fiber, whereas with the 980-nm laser irradiation, significant changes were demonstrated only at the application site.…”

Section: Wwwpainphysicianjournalcommentioning

confidence: 99%

Percutaneous Lumbar Laser Disc Decompression: An Update of Current Evidence

Singh¹

2013

Pain Phys

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Background: Since the descriptions by Mixter and Barr of surgical treatment for rupture of the intervertebral disc in 1934, open surgical procedures have become a common practice. Disc herniations are often classified as being contained or non-contained. The results of open surgical discectomy for contained disc herniation have been poor. Consequently, several less invasive techniques have been developed including percutaneous lumbar laser disc decompression. Study Design: A systematic review of the literature of percutaneous lumbar laser disc decompression. Objective: The objective of this systematic review is to evaluate and update the clinical effectiveness of percutaneous lumbar laser discectomy in managing radicular pain secondary to contained disc herniation. Methods: The available literature on lumbar laser disc decompression in managing chronic low back and lower extremity pain was reviewed. Quality assessment and clinical relevance of randomized trials were graded according to the Cochrane Musculoskeletal Review Group criteria for interventional techniques, and observational studies according to the Newcastle-Ottawa Scale criteria. The level of evidence was classified as good, fair, and limited or poor based on the quality of evidence developed by the U.S. Preventive Services Task Force (USPSTF). Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966 to September 2012, and manual searches of the bibliographies of known primary and review articles. Outcome Measures: Pain relief was the primary outcome measure. Other outcome measures were functional improvement, improvement of psychological status, opioid intake, and return-to-work. Short-term effectiveness was defined as effectiveness lasting one year or less, whereas, long-term effectiveness was defined as benefit persisting for greater than one year. Results: Based on USPSTF criteria, the indicated level of evidence for percutaneous lumbar laser disc decompression is limited for short- and long-term relief. Limitations: Although laser discectomy has been utilized for many years, there is a paucity of randomized clinical trials. Conclusion: This systematic review shows limited evidence for percutaneous lumbar laser disc decompression. Key words: Intervertebral disc disease, chronic low back pain, disc herniation, disc protrusion, radiculitis, contained disc herniation, mechanical disc decompression, percutaneous lumbar laser discectomy, laser assisted spinal endoscopy

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Section: Wwwpainphysicianjournalcommentioning

confidence: 99%

Percutaneous Lumbar Laser Disc Decompression: An Update of Current Evidence

Singh¹

2013

Pain Phys

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“…Besides the ability to directly visualize the compressive pathology rather than only relying on preoperative imaging and intraoperative fluoroscopy typical of percutaneous laser disc decompression (PLDD), the endoscopic approach affords the surgeon the ability to tailor the operation based on the visualized pathology by addressing more complex structural problems of the diseased motion segment. While PLDD is limited to the shrinkage of the intervertebral disc tissue either via direct thermal or vaporization effects [11][12][13] dictated by the type of laser technology chosen for the operation, the use of power burrs, drills, and advanced cutting rongeurs during a percutaneous endoscopic disc decompression (PEDD) allows bony resection which is often required to achieve adequate decompression in patients with advanced degenerative cervical spine disease. This seemingly trivial and obvious distinction creates the discussion on which procedure best suits what type of cervical disc herniation.…”

Section: Introductionmentioning

confidence: 99%

Patient selection criteria for percutaneous anterior cervical laser versus endoscopic discectomy

Hellinger¹,

Knight

Telfeian

et al. 2022

Lasers Surg Med

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Background: Percutaneous anterior laser and anterior endoscopic cervical spine surgery are associated with less approach trauma than conventional open cervical spine surgery. The literature illustrating their appropriate use corroborated with objective outcome evidence is scarce. The authors were interested in comparing the clinical outcomes following percutaneous laser disc decompression (PLDD) versus percutaneous endoscopic disc decompression (PEDD). © 2021 Wiley Periodicals LLC. Materials and Methods: Thirty patients with soft contained symptomatic cervical disc herniations and an average age of 50.5 years (range 26 -68 years; 16 males and 14 females) were prospectively enrolled in 2 groups of 15 patients to be either treated with PLDD or PEDD. All patients underwent PLDD or PEDD under local anesthesia and sedation. Clinical outcomes were assessed with the Macnab criteria VAS score for arm pain. Complications and reoperations were recorded. Results: There were significant reductions in the VAS score for arm pain from preoperative 8.4 ± 2.5 to 3.1 ± 1.2 in the PLDD group (P < 0.03), and from preoperative 8.6 ± 2.7 to 2.4 ± 1.1 (P < 0.01) in the PEDD group. In the PLDD group, Macnab outcomes were excellent in 21% of patients, good in 44%, fair in 21%, and poor in 14%. In the PEDD group, Macnab outcomes were excellent in 14% of patients, good in 32%, fair in 12%, and poor in the remaining 12%. There were no statistically significant differences in clinical outcomes between the PLDD and the PEDD group. There were no approach-related or surgical complications. Conclusions: Tissue trauma is significantly reduced with laser and endoscopic surgery techniques. PLDD and PEDD are both suitable for the specific indication of soft, symptomatic contained cervical disc herniations. The authors' small prospective cohort study indicates that PLDD and PEDD are options for cervical decompression surgery when medical comorbidities or preferences by patients and surgeons dictate more minimally invasive strategies.

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“…Although IVDD often occurs simultaneously along the entire vertebral column, the discs do not undergo the same levels of degenerative changes at the time for prophylactic treatment. Currently, PLDA of dogs or percutaneous laser disc decompression in humans is performed on the most common sites of thoracolumbar IVDD, and with the same laser fluence applied to each thoracolumbar disc regardless of the differences in the degenerative condition among the discs. It is recognizable that adapting the laser fluence based on the extent of the mineralization of the disc will likely improve the outcomes of PLDA by minimizing under‐ or over‐ablation; however, disc‐specific PLDA procedure is not advocated, at least in dogs, due largely to the limit that the diagnostic imaging has in determining the degenerative extent of the disc in the clinical work‐flow of PLDA.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous single‐fiber reflectance spectroscopy of canine intervertebral disc: Is there a potential for in situ probing of mineral degeneration?

Piao

McKeirnan

Sultana³

et al. 2014

Lasers Surg Med

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Impact of infrared laser light‐induced ablation at different wavelengths on bovine intervertebral disc ex vivo: Evaluation with magnetic resonance imaging and histology

Abstract: The 1,470-nm laser light had an effect in the whole nucleus pulposus and not only at the site of the quartz fiber, whereas with the 980-nm laser irradiation, significant changes were demonstrated only at the application site.

Cited by 12 publications

References 40 publications

Percutaneous Lumbar Laser Disc Decompression: An Update of Current Evidence

Percutaneous Lumbar Laser Disc Decompression: An Update of Current Evidence

Patient selection criteria for percutaneous anterior cervical laser versus endoscopic discectomy

Percutaneous single‐fiber reflectance spectroscopy of canine intervertebral disc: Is there a potential for in situ probing of mineral degeneration?

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