Radiological analysis of herniated disc size changes after percutaneous laser disc decompression

Area of Science:

• Minimally invasive spine procedures
• Interventional radiology
• Orthopedic surgery

Background:

• Symptomatic lumbar disc herniation causes significant low back pain and sciatica.
• Minimally invasive techniques like percutaneous laser disc decompression (PLDD) are alternatives to open surgery.
• The efficacy of PLDD for lumbar disc herniation remains under investigation.

Purpose of the Study:

• To evaluate the effectiveness of PLDD in patients with lumbar disc protrusions and contained herniations.
• To assess quantitative changes in herniated disc area using MRI post-PLDD.
• To correlate imaging findings with patient outcomes and satisfaction.

Main Methods:

• A cohort of 58 patients with lumbar radiculopathy due to disc herniation underwent PLDD.
• Post-procedure MRI (2 months) was used to measure axial and sagittal disc areas.
• Patient-reported pain, clinical outcomes, and satisfaction levels were recorded.

Main Results:

• PLDD resulted in a statistically significant reduction in both axial (median 35.9%) and sagittal (median 49.3%) disc areas.
• All patients demonstrated a reduction in herniated disc size, with a median overall reduction ratio of 52.7%.
• Significant P-values (< 0.0001) indicate the reliability of the observed disc area reductions.

Conclusions:

• PLDD is an effective treatment for reducing herniated disc size in selected patients.
• It is a valuable option for contained lumbar disc herniations unresponsive to conservative management.
• PLDD provides a statistically significant reduction in disc size, serving as an alternative to open surgery.