RESULTS OF A CLINICAL-TRIAL OF THE HOLMIUM-YAG LASER IN DISC DECOMPRESSION UTILIZING A SIDE-FIRING FIBER - A 2-YEAR FOLLOW-UP

Background and Objective: Laser-assisted disc decompression (LADD) is an operative technique for the treatment of symptomatic, nonsequestere d herniated nucleus pulposus that has failed to respond to conservativ e treatment. The current study reports a-year follow-up data. Study De sign Materials and Methods: Patients were evaluated by an independent interviewer postoperatively, and at 1 week, 3 months, 6 months, 1 year , and 2 years. Ratings were based upon the modified Macnab criteria. A ll patients evidenced primarily leg pain with or without back pain tha t had failed a minimum of 6 weeks of conservative treatment. Patients with lateral recess or central stenosis, sequestered discs, or predomi nantly scar tissue from a previous discectomy were not considered cand idates for LADD. Results: Utilizing postoperative follow-up at 2 years , a surgical success rate of 86.9% was achieved. For patients requirin g an additional LADD procedure, results at 6-month follow-up yielded a surgical success rate of 80%. Conclusion: LADD appears to be a viable treatment modality for symptomatic, nonsequestered lumbar disc hernia tion recalcitrant to conservative treatment. LADD may represent a more cost-effective and safer alternative to traditional surgical procedur es. (C) 1996 Wiley-Liss, Inc.