Percutaneous Microdecompressive Endoscopic Cervical Discectomy with Recently Added Application of Non-Ablative Lower Laser Energy (Laser Thermodiskoplasty)-140 cases, 1997

Chiu, John C.; Clifford, Thomas; Greenspan, Mark; Negron, Felix; Princenthal, Robert; Carter, Joan

doi:10.1097/00006123-199709000-00072

Cited by 4 publications

(10 citation statements)

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“…In properly performed applications at doses and frequencies in parallel to the endplate and in accurately selected cases, complications are very few. However, tetraplegia cases after cervical application reported by authors such as Martin Knight raised questions about thermal penetration in spinal cord and radiation safety [1,11]. PLDD is the procedure in which 400-1000 joule Nd YAG laser energy is transfered into the disc for 10-30 minutes.…”

Section: Intradiscal Therapiesmentioning

confidence: 99%

“…Casper recommends total energy of 1200 j at 13 Watt, 10 Hertz for 5 minutes of relapse time. Table 1 shows the acceptable doses proposed after multi-center trials [3,11,12,13,14,15,16,17].…”

Section: Intradiscal Therapiesmentioning

confidence: 99%

“…Coblation effect provides plasma conversion at low temperature, which is different from multipolar radiofrequency. This can be called cold ablation [3,4,9,10,11,12].…”

mentioning

confidence: 99%

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Laser and Radiofrequency Energy Applications in the Percutaneous Endoscopic Surgical Treatment of Degenerative Disc Disease: Should be abandoned?

2023

PSMPH

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The word LASER stands for Light Amplification by Stimulated Emission of Radiation. According to this abbreviation that summarizes the energy generation; it is the light that occurs when the crystal between two full and semi reflective mirrors is exposed to intensified energy amplification the type of laser is named with the substance in the liquid crystal [1,2]. Laser was first applied in the musculoskeletal system w by Whipple in 1984 using C02 laser. Classification according to the laser optic

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Section: Intradiscal Therapiesmentioning

confidence: 99%

Section: Intradiscal Therapiesmentioning

confidence: 99%

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Laser and Radiofrequency Energy Applications in the Percutaneous Endoscopic Surgical Treatment of Degenerative Disc Disease: Should be abandoned?

2023

PSMPH

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“…For many decades, laminectomy has no longer been considered a viable option for treating TDH due to its’ high risk of paralysis/increased morbidity [ Table 1 ]. [ 1 , 4 , 5 , 7 ] Rather, transthoracic, posterolateral (i.e., costotransversectomy/lateral extracavitary) and occasionally transfacet/ transpedicular approaches are utilized to manage anterior/anterolateral TDH. More calcified and/or more midline lesions may warrant bilateral approaches and fusions.…”

Section: Introductionmentioning

confidence: 99%

“…Several studies emphasized that performing laminectomy for TDH has been abandoned for decades [ Table 1 ]. [ 1 , 4 , 5 , 7 ] In 1985, Arce and Dohrmann studied 129 patients undergoing surgery for thoracic disk herniations and noted; “Regarding the results of surgical treatment, there was a success rate ranging from 57% for decompressive laminectomy to over 80% for the posterolateral, lateral, and transthoracic approaches.” They concluded; “Consider that laminectomy was the operation of choice for patients with thoracic disk disease; when evidence began to mount that neurological worsening was a laminectomy-related complication, the procedure ceased to be used in the treatment of thoracic disk lesions”. [ 1 ] Chen (2000) subsequently discussed the efficacy, safety, and surgical outcomes for TDH utilizing transthoracic, lateral extracavitary, transpedicular, and/ or endoscopic procedures”.…”

Section: Introductionmentioning

confidence: 99%

Perspective: Transthoracic, posterolateral, or transpedicular approaches to thoracic disks, not laminectomy

Epstein,

Abulnick

2023

Surgical Neurology International

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Background: Anterior transthoracic, posterolateral (i.e., costotransversectomy/lateral extracavitary), and transpedicular approaches are now utilized to address anterior, anterolateral, or lateral thoracic disk herniations (TDH). Notably, laminectomy has not been a viable option for treating TDH for decades due to the much lower rate of acceptable outcomes (i.e., 57% for decompressive laminectomy vs. over 80% for the posterolateral, lateral, and transthoracic procedures), and a higher risk of neurological morbidity/paralysis. Methods: Patients with TDH averaged 48-56.3 years of age, and presented with pain (76%), myelopathy (61%-99%), radiculopathy (30%-33%), and/or sphincter loss (16.7%-24%). Those with anterior/anterolateral TDH (30-74%) were usually myelopathic while those with more lateral disease (50-70%) exhibited radiculopathy. Magnetic resonance (MR) studies best defined soft-tissue/disk/cord pathology, CAT scan (CT)/Myelo-CT studies identified attendant discal calcification (i.e. fully calcified 38.9% -65% vs. partial calcification 27.8%), while both exams documented giant TDH filling > 30 to 40% of the canal (i.e., in 43% to 77% of cases). Results: Surgical options for anterior/anterolateral TDH largely included transthoracic or posterolateral approaches (i.e. costotransversectomy, lateral extracavitary procedures) with the occasional use of transfacet/transpedicular procedures mostly applied to lateral disks. Notably, patients undergoing transthoracic, lateral extracavitary/costotransversectomy/ transpedicular approaches may additionally warrant fusions. Good/excellent outcomes were quoted in from 45.5% to 87% of different series, with early postoperative adverse events reported in from 14 to 14.6% of patients. Conclusion: Anterior/anterolateral TDH are largely addressed with transthoracic or posterolateral procedures (i.e. costotransversectomy/extracavitary), with a subset also utilizing transfacet/transpedicular approaches typically adopted for lateral TDH. Laminectomy is essentially no longer considered a viable option for treating TDH.

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Imaging for Peripheral Nerve Disorders

Filler¹

2011

Youmans Neurological Surgery

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Percutaneous Microdecompressive Endoscopic Cervical Discectomy with Recently Added Application of Non-Ablative Lower Laser Energy (Laser Thermodiskoplasty)-140 cases, 1997

Cited by 4 publications

References 0 publications

Laser and Radiofrequency Energy Applications in the Percutaneous Endoscopic Surgical Treatment of Degenerative Disc Disease: Should be abandoned?

Laser and Radiofrequency Energy Applications in the Percutaneous Endoscopic Surgical Treatment of Degenerative Disc Disease: Should be abandoned?

Perspective: Transthoracic, posterolateral, or transpedicular approaches to thoracic disks, not laminectomy

Imaging for Peripheral Nerve Disorders

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