In the procedure of percutaneous laser disc decompression, laser energy is transmitted through a thin optical fiber into the disc.
The aim of PLDD is to vaporize a small portion of the inner core. The ablation of a relatively small volume of the inner core results in an important reduction of intra-discal pressure, thus inducing a reduction of disc herniation.
PLDD is the minimally-invasive medical procedure developed by Dr. Daniel S.J. Choy in 1986 that uses a laser beam to treat back and neck pain caused by a herniated disc.
Percutaneous laser disc decompression (PLDD) is the utmost minimally invasive percutaneous laser technique in the treatment of disc hernias, cervical hernias, dorsal hernias (except for the segment T1-T5), and lumbar hernias. The procedure uses laser energy to absorb the water within the herniated nucleus pulpous creating a decompression.
This DUAL platform is based on the absorption characteristics of both 980 nm and 1470 nm wavelengths, which, thanks to its outstanding interaction in water and haemoglobin and moderate penetration depth into disc tissue, enables procedures to be carried out safely and ac curately, especially in proximity of delicate anatomical structures. Microsurgical precision is guaranteed by the technical characteristics of the special PLDD.
What's the PLDD?
Percutaneous laser disc decompression (PLDD) is a procedure in which herniated intervertebral discs are treated by reduction of intradiscal pressure through laser energy. This is introduced by a needle inserted into the nucleus pulposus under local anesthesia and fluoroscopic monitoring. The small volume of nucleus vaporized results in a sharp fall of intradiscal pressure, with consequent migration of the herniation away from the nerve root. It is firstly developed by Dr. Daniel S.J. Choy in 1986. PLDD has proven to be safe and effective. It is minimally invasive, is performed in an outpatient setting, requires no general anesthesia, results in no scarring or spinal instability, reduces rehabilitation time, is repeatable, and does not preclude open surgery should that become necessary. It is an ideal choice for patients with poor results in non-surgical treatment. A needle is inserted into the affected area of the ntervertebral disc and laser fiber is injected through it to burn the nucleus pulposus with a laser. Tissue interaction with DUAL laser fibers, which allow for surgical effectiveness, ease of handling, and maximum safety. The use of flexible tactile laser fibers with core diameters of 360 micron in combination with the microsurgical PLDD enables a very precise and accurate access and intervention to sensitive areas like the cervical and lumbar disc zones on the basis of clinical therapeutic needs. PLDD laser treatments are mostly used after non-successful conventional therapeutic options under strict MRT/ CT control.
PLDD procedure is performed using local anesthesia. Optical fiber is inserted in special cannula under fluoroscopic guidance. After applying contrast to the facet it is possible to check cannula's position and the condition of the disc bulge. Starting laser initiates decompression and lowers intradiscal pressure.
The procedure is done from the posterior-lateral approach with no interference to vertebral canal, therefore, there is no possibility of damaging a reparative treatment, but there is no possibility to reinforce annulus fibrosus. During PLDD disc volume is minimally decreased, however,disc pressure can be significantly lowered. In case of using laser to disc decomperssion, small amount of nucleus pulposus evaporates.
The sterile kit include a 400/600 micron bare fifiber with jacket protection, 18G/20G needles (length 15.2cm), and a Y Connector allowing fifiber entry and suction. The connector and needles are individually packed to enable maximum flflexibility in treatment.
