Review article
https://doi.org/10.20471/acc.2023.62.s4.9
Percutaneous Laser Disc Decompression for Lumbar Radicular Pain: A Systematic Review of Pubmed in the Last Five Years
Ivan Radoš
; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Centre Osijek, Croatia
Mirjana Lončarić Katušin
; Department of Anesthesiology, Resuscitation and Intensive Care Medicine, General Hospital Karlovac, Karlovac, Croatia
Dino Budrovac
; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Centre Osijek, Croatia
Iva Dimitrijević
; Department of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Centre Osijek, Croatia
Dijana Hnatešen
; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Centre Osijek, Croatia; Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Ivan Omrčen
; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Centre Osijek, Croatia
Abstract
The most common causes of lumbar radicular pain are pathological changes in the
intervertebral disc. Lumbar disc herniation (LDH) is the most common cause of lumbosacral radicular
syndrome. It affects 1-2% of the general population, burdening health services and the economy worldwide.
Excessive scar tissue after lumbar microdiscectomy can increase postoperative pain. Postoperative
fibrosis is one of the most important causes of failed back surgery syndrome after lumbar disc surgery.
Percutaneous laser disc decompression (PLDD) is a minimally invasive procedure in which thermal
energy produced by a LASER probe is used to reduce the intervertebral disc herniation located within
the annulus fibrosus. Evaporation of a small volume in a closed hydraulic space (nucleus pulposus) leads
to decreased intradiscal pressure. It causes a thermal “shrinkage effect” with the retreat of the herniated
disc and the decompression of the nerve root, which reduces lumbar radicular pain. Previous research
has shown effective reduction of pain after PLDD and only a small number of complications of the
procedure itself. PLDD is a safe and effective procedure in well-selected patients. Unfortunately, there is
still a need for extensive, randomized prospective studies on PLDD in lumbar radicular pain in order to
confirm or dispute the results obtained so far.
Keywords
percutaneous laser disc decompression; discectomy; lumbar radicular pain; disc protrusion
Hrčak ID:
316010
URI
Publication date:
1.11.2023.
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