**Laser Discectomy**

Innovation and technology allow laser assisted surgeries to be utilized on a variety of medical conditions—safely and effectively. People suffering from pain caused by a herniated or "slipped" disc in the spine, now may find relief through minimally invasive laser surgery.

Initial treatment for a herniated disc is usually conservative such as physical therapy or anti-inflammatory medication to relieve pain and restore function. If symptoms persist, treatment may lead to a surgery called a discectomy. You and your doctor will discuss the best treatment based on your diagnosis. Laser discectomy replaces conventional spine surgery in 10-12 percent of disc cases requiring surgery.

In treatment of Lumbar Disc disease, it is useful and advantageous. Laser discectomy is an out patient procedure with one-step insertion of a needle into the disc space. Disc material is not removed, instead nucleus pulposus is burned by the Laser. In comparison to other discectomy procedures, Laser Discectomy is least invasive.

The aim of Pacutaneous Laser Disc Decompression (PLDD) is to vaporise a small portion of nucleus pulposus of an offending disc, thereby reducing the volume of a diseased disc and pressure within it, which is believed to exert an effect on noncontiguous portion of nucleus that is protuding through the annulus fibrosus and abutting on exiting nerve root.

A small change in disc nucleus volume can exert disproportionately large change in the intradiscal pressure.

Outcomes of a Laser Discectomy
Our initial results and those in the U.S.A. suggest that, in properly selected patients, Laser Discectomy using the Holmium/Diode Surgical Laser System is a safe and effective alternative to open operative discectomy. Our early studies suggest that 95% of patients with primary compressive nerve root symptoms are satisfied with the results of laser discectomy one year after surgery and 92% are satisfied by the end of the second year and 90% at the end of year 3.

The advantages of the Laser Discectomy over conventional surgery include:

  • Performed as an out patient procedure.
  • Do not preclude alternative surgical options.
  • Reduced risk of complications.
  • Usually provide immediate relief of symptoms.
  • Reduced soft tissue injury.
  • No bone is sacrificed.
  • No epidural fibrosis (scarring about the cord) as a result of the surgical procedure.
[A]. Computerized model of hemiated disc - pre-operative. [B]. Computerized model of reduced hemiated disc - post-operative.

Dr Deepak Vangani is first Neurosurgoen in India to perform Holmium/Diode Laser Disc decompression with more successful procedures performed to date. FDA approved, use of the holmium/diode laser for spine surgery has grown in popularity and become widely accepted due to its safety and effectiveness. PLDD is even less invasive than Chymopapaine Mechanical Discectomy, APD and Microdiscetromy. It therefore provides a method of treatment for a large population of patients suffering from back and leg pain secondary to herniated disc and internal disc disruption syndrome. Additionally, patients who have failed to meet indications of open spine surgery may be candidates for a less invasive treatment such as PLDD.