PERCUTANEOUS LASER DISK DECOMPRESSION UNDER CT AND FLUOROSCOPIC GUIDANCE - INDICATIONS, TECHNIQUE, AND CLINICAL-EXPERIENCE

The aim of percutaneous laser disk decompression (PLDD) is to vaporize a small portion of the nucleus pulposus of an intervertebral disk, th ereby reducing the volume and pressure of a diseased disk. This minima lly invasive technique can be performed in patients who need surgical intervention for disk herniation with leg pain. PLDD is usually perfor med under fluoroscopic guidance with or without diskoscopy. However, i t can also be performed under dual computed tomographic (CT) and fluor oscopic guidance as an outpatient procedure. CT and fluoroscopic guida nce increases the safety and accuracy of PLDD, with high precision of instrument guidance, direct visualization of nucleus pulposus vaporiza tion, and reduced risk of complications. Of 119 patients with lumbar d isk herniation treated with PLDD under CT and fluoroscopic guidance, 9 1 (76.5%) had a good or fair response. PLDD performed with CT and fluo roscopic guidance appears to be a safe and effective treatment for her niated intervertebral disks.