Complications of non-endoscopic percutaneous laser disc decompression and nucleotomy with the neodymium: YAG laser...

In this review, we discuss how nonendoscopic percutaneous laser disc decompression (PLDD) and nucleotomy, using the YAG laser 1064, now has reinforced itself as a minimally invasive procedure in discogenic, vertebral pain syndromes, created by bulging, protrusions, and contained and uncontained extrusions in all areas of the spine. The rate of complication is an important criterion of the application of this new method. 3377 patients were treated with this method in the period of November 11, 1989 to April 30, 2002. While 356 patients' cervical spine was operated on, a further 38 patients had their thoracic spine operated on. Six weeks later, a prospective, consecutive control followed with an uninterrupted recording. Subsequently, all complications that occurred in this time frame were recorded. A comparison was carried out between the complication rate as covered by the literature of other intradiscal percutaneous methods and open disc surgery. Using the Nd-YAG laser 1064 nm, PLDD is generally evaluated with a complication rate of 0.5%. In the cervical spine area, the complication rate was 1.0%. No significant complications followed the thoracic intervention. In comparison to figures suggested by the relevant literature regarding possible complications with other procedures, this particular procedure is relative risk-free. In conjunction with the satisfying results regarding pain and paralysis removal, the extraordinarily low complication density of Nd-YAG PLDD culminates in the recommendation that the procedure should be applied to patients who are between unsuccessful conservative therapy and other operative methods.