Early experience with laser disc decompression. A percutaneous method

A study over an 18-month period involved 40 patients with a contained HNP who underwent laser-assisted percutaneous lumbar discectomy utilizing KTP/532. Access to the disc was via an 18-gauge probe followed by dilating cannulas under fluoroscopic control. A 400 um quartz fiber was utilized. The laser power was set between 10 and 15 watts and the exposure duration at 0.5 seconds and repeated with intervals of 0.5 seconds. Two of six patients required an open conventional L4-5 discectomy; four refused additional surgery. These failures are considered probably secondary to a subligamentous location of disc. Based upon early results, laser-assisted percutaneous lumbar discectomy with KTP laser appears to be a viable alternative to automated percutaneous discectomy in selected cases and perhaps an improvement over other techniques.