Disc herniation surgery with percutaneous laser disc decompression (PLDD) is one of the so-called “minimally invasive” treatments for disc herniation. Treatment is performed percutaneously, so morbidity is expected to be lower and the recovery period shorter than with conventional surgery.
Due to the minimally invasive nature and the fact that return to work is usually possible within a few days after treatment, PLDD seems to be one of the better alternatives to conventional surgery.
For appropriate patients, percutaneous discectomy may help alleviate the symptoms of back and leg pain, including sciatica and radiculopathy, and even pure axial pain caused by a “central focal bulge” or central disc bulge.
Percutaneous discectomy is a widely accepted treatment for patients with small hernias. It can also be a promising option for patients with large hernias in whom open surgery is not considered an appropriate treatment.
Disc herniation surgery
Disc herniation surgery with the Percutaneous Discectomy method is very simple. The patient receives a local anesthetic and possibly mild sedation; no general anesthesia is required. Inserting the needle is simple, with little pain. Once the needle is inserted into the disc, the decompression of the disc itself takes only a few minutes. The whole procedure takes about 30 minutes.
Appropriate diagnostic evaluation before this procedure almost always includes MRI of the cervical or lumbosacral spine, as well as a complete history and physical examination. Patients with large herniated discs may not be candidates for this procedure. Patients with bulging discs, small hernias with closed walls, moderate disc herniations can be good candidates for this procedure.
Indications:
- Convex discs
- Mild disc herniation
- Moderate disc herniation
- Central disc herniation with central pain
- Back and leg pain
- Sciatica and radiculopathy
Read more: Endoscopic disc herniation surgery
Recovery after intervention
Recovery after surgery is not required. Patients usually feel a little pain after the procedure. Patients are required to avoid lifting and strenuous exercise for a period of time. The patient can resume inactive work after a week or two.
Patients with more physically demanding occupations may have to wait longer to return to work. Physical therapy may be prescribed.
Possible complications after PLDD
Complications after PLDD are rare, but include nerve root irritations and dural injuries, and damage to retroperitoneal structures is also possible. Postoperative bleeding and delayed infections may also occur.
