Efficacy of the Percutaneous Laser Disc Decompression in Patients with Lumbar Disc Herniation

Yıl 2017, , 130 - 133, 01.08.2017

Mustafa Kemal İlik

https://doi.org/10.5505/kjms.2017.57855

Öz

Aim: The aim of this study is to examine the safety and efficacy
of the Percutaneous Laser Disc Decompression which is applied
to patients with lower back pain and radiculopathy due to lumbar
disc hernia.
Material and Method: In this study, we retrospectively examined
the data of patients who underwent Percutaneous Laser
Disc Decompression. Consecutive 71 patients who underwent
Percutaneous Laser Disc Decompression between 2014 and 2015
were included in the study (average age 38.6±7.3). Visual Analog
Scale was used in order to evaluate the pain levels of patients.
Preoperative Visual Analog Scale scores were compared to scores
obtained from the last examination. Student paired-sample t test
was used in order to analyze all parameters by considering the
statistical significance as p<0.05.
Results: There were 15 patients who were operated at L3–4 segment,
there were 30 patients who were operated at L4–5 segment
and there were 26 patients who were operated at L5-S1 segment.
Mean Visual Analog Scale scores of patients before the operation
decreased from 6.5±1.2 to 3.4±0.7 in the last neurological examination.
All changes were statistically significant.
Conclusion: In selected cases, Percutaneous Laser Disc Decompression
is an effective and safe technique in the short and medium
term. 

Anahtar Kelimeler

lumbar disc herniation; percutaneous laser decompression; pain

Lomber Disk Hernili Hastalarda Perkütan Lazer Disk Dekompresyonunun Etkinliği

Öz

Amaç: Bu çalışmanın amacı lomber disk hernisine bağlı bel ağrı-
sı ve radikülopatisi olan hastalara uygulanan Perkütan Lazer Disk
Dekompresyonu’nun etkinliğini ve güvenliğini araştırmaktır.
Materyal ve Metot: Çalışma Perkütan Lazer Disk Dekompresyonu
uygulanan hastaların dosyalarının retrospektif olarak taranması ile hazırlandı.
2014–2015 yıllarında Perkütan Lazer Disk Dekompresyonu
uygulanan ardışık 71 hasta (ortalama yaş 38,6±7,3) çalışmaya dahil
edildi. Visual Analog Skala hastaların ağrılarının değerlendirmesi için
kullanıldı. Preoperatif Visual Analog Skala skorları, son muayenedeki skorlarıyla karşılaştırıldı. Tüm parametreler Student paired-sample t
test ile analiz edildi ve p<0,05 istatistiksel olarak anlamlı kabul edildi.
Bulgular: L3–4 mesafesinden opere olan 15, L4–5 mesafesinden
opere olan 30, L5-S1 mesafesinden opere olan 26 hastaydı.
Hastaların operasyondan önceki ortalama Visual Analog Skala
skoru 6,5±1,2’ten son nörolojik muayenelerinde ise 3,4±0,7’e düş-
müştü. Tüm değişiklikler istatistiksel olarak anlamlıydı.
Sonuç: Seçilmiş olgularda Perkütan Lazer Disk Dekompresyonu’nun
kısa ve orta dönemde etkin ve güvenli bir yöntem olduğu
görülmüştür.

Anahtar Kelimeler

lomber disk hernisi; perkütan lazer dekompresyon; ağrı

Kaynakça

• 1. Jacobs WC, Van Tulder M, Arts M, Rubinstein SM, van Middelkoop M, Ostelo R, et al. Surgery versus conservative management of sciatica due to a lumbar herniated disc: A systematic review. Eur Spine J 2011;20:513–22.
• 2. Manchikanti L, Singh V, Calodney AK, Helm S 2nd, Deer TR, Benyamin RM, et al. Percutaneous lumbar mechanical disc decompression utilizing Dekompressor®: an update of current evidence. Pain Physician 2013;16:1–24.
• 3. Nachemson AL. Newest knowledge of low back pain: A critical look. Clin Orthop 1992;279:8–20.
• 4. Gupta S, Gupta M, Nath S, Hess GM. Survey of European pain medicine practice. Pain Physician 2012;15:983–94.
• 5. Rubinstein SM, van Middelkoop M, Assendelft WJ, de Boer MR, van Tulder MW. Spinal manipulative therapy for chronic low-back pain: An update of a Cochrane review. Spine 2011;36:825–46.
• 6. Erbas YC, Pusat S, Erdogan E. Percutaneous Laser Disc Decompression: Retrospective Analysis of 197 Cases and Review of The Literature. Turk Neurosurg 2015;25:766–870.
• 7. Singh V, Manchikanti L, Benyamin RM, Helm S, Hirsch JA. Percutaneous lumbar laser disc decompression: A systematic review of current evidence. Pain Physician 2009;12:573–88.
• 8. Brouwer PA, Brand R, van den Akker-van Marle ME, Jacobs WC, Schenk B, van den Berg-Huijsmans AA, et al. Percutaneous laser disc decompression versus conventional microdiscectomy in sciatica: a randomized controlled trial. Spine J 2015;15:857– 65.
• 9. Menchetti PPM, Bini W. Percutaneous treatment in lumbar disc herniation. In: Minimally Invasive Surgery of the Lumbar Spine. Springer Verlag 2014:83–105.
• 10. Choy D. Percutaneous laser disc decompression (PLDD). J Clin Laser Med Surg 1998;16:325–33.
• 11. Menchetti PPM, Canero G, Bini W. Percutaneous laser discectomy: Experience and long term follow-up. Acta Neurochir Suppl 2011;108:117–21.
• 12. Gronemeyer DH, Buschkamp H, Braun M, Schirp S, Weinsheimer PA, Gevargez A. Image-guided percutaneous laser disk decompression for herniated lumbar disks: A 4-year followup in 200 patients. J Clin Laser Med Surg 2003;21:131–8.
• 13. Lee SH, Kang HS. Percutaneous endoscopic laser annuloplasty for discogenic low back pain. World Neurosurg 2010;73:198– 206.
• 14. Kim PS. Nucleoplasty. Tech Reg Anesthesia Pain Man 2004;8:46–52.