Laser in Neurosurgery

In the last 15 years, minimally invasive surgical procedures have been replacing the conventional open surgical ones in almost all areas of medicine. The percutaneous laser disc decompression generally attends to a class of minimally-invasive surgical procedures suggested for reducing intra-disc pressure.

They are more popular today because knowledge of the spinal anatomy has improved, clinical outcomes of conventional procedures have proven unsatisfactory, and imaging techniques have significantly improved.

The advantages of these alternative methods over surgery include a reduction in the recovery time, faster treatment and rehabilitation and lower social and economic costs.

The main purpose of percutaneous laser disc decompression, as a treatment for contained herniated (nonextruded) discs, is to selectively decrease the amount of the nucleus pulposus material, maintaining the adjacent tissues intact. Initially addressed only for lumbar discs treatment, the technique is also feasible for thoracic and cervical disc.

What is Percutaneous Laser Disc Decompression (PLDD)?

PLDD involves insertion of a micro-needle under X-Ray guidance into the disc nucleus. A fiber is then inserted through the needle and used to deliver laser energy to the nucleus. During the procedure, 1470nm laser energy vaporizes a tiny portion of the disc, decompressing it, so the patient doesn’t feel the pain of the disc pressing on the nerve root.

Why 1470nm laser wavelength?

The 1470nm laser light beam has suitable low melanin and hemoglobin absorption for skin penetration and respectively high water and fat absorption for selective photothermolysis. The wave of the 1470nm laser is absorbed by cellular water 40 times better than the wave of 810/980 nm laser and 80 times better than the wave of Nd: YAG 1064 nm laser. The higher efficacy of the 1470nm diode laser system enables to reduce energy emission with comparable clinical results to high power lasers of different  wavelengths. 

Within the PLDD procedure the 1470nm SWING laser is able to deliver a precise thermal ablation zone, resulting in an accurate reduction in nucleus pulposus material and therefore a consequential accurate reduction in intradiscal pressure.

What are the indications?

Clinical situations where there is a need to rapidly decrease the pressure inside the intervertebral disc and reduce disc volume in cervical, lumbar and thoracic regions. For example, when there is a progression of Degenerative Spinal syndromes causing herniated (Not prolapsed) disc.

 

 

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