Efficacy of percutaneous laser disc decompression on lumbar spinal stenosis

Ren, Longxi; Han, Zhengfeng; Zhang, Jianhua; Zhang, Tongtong; Yin, Jian; Liang, Xin-Gang; Guo, Han; Zeng, Yanjun

doi:10.1007/s10103-013-1429-8

Cited by 8 publications

(4 citation statements)

References 12 publications

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“…The complication rate (only infectious discitis) was 0.4 % [3]. Ren performed PLDD with Nd:YAG laser in treating cervical and lumbar spondylosis, and the clinical results were satisfactory [4,7,8]. According to Gevargez's report, 980 nm diode laser proved to be an efficient tool for PLDD on non-sequestered herniated lumbar discs due to enhanced tissue absorption [5].…”

Section: Discussionmentioning

confidence: 95%

Comparison of the ablation ability of nucleus pulposus after 1,064 nm Nd:YAG laser and 980 nm diode laser radiation

Yin

Han

Guo

et al. 2014

Eur J Orthop Surg Traumatol

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Section: Discussionmentioning

confidence: 95%

Comparison of the ablation ability of nucleus pulposus after 1,064 nm Nd:YAG laser and 980 nm diode laser radiation

Yin

Han

Guo

et al. 2014

Eur J Orthop Surg Traumatol

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“…Laser therapy has been used successfully to treat bulging or herniated intervertebral disc disease resulting in symptomatic spinal canal compression and the interaction of laser energy with intervertebral discs evaluated for common surgical lasers . However, utilization of lasers to specifically ablate hypertrophied ligamentum flavum as seen in degenerative LSS has not yet been explored.…”

Section: Discussionmentioning

confidence: 99%

Ablation of porcine ligamentum flavum with Ho:YAG, q‐switched Ho:YAG, and quadrupled Nd:YAG lasers

et al. 2015

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Background and ObjectivesLigamentum flavum (LF) is a tough, rubbery connective tissue providing a portion of the ligamentous stability to the spinal column, and in its hypertrophied state forms a significant compressive pathology in degenerative spinal stenosis. The interaction of lasers and this biological tissue have not been thoroughly studied. Technological advances improving endoscopic surgical access to the spinal canal makes selective removal of LF using small, flexible tools such as laser‐coupled fiber optics increasingly attractive for treatment of debilitating spinal stenosis. Testing was performed to assess the effect of Ho:YAG, Q‐switched Ho:YAG, and frequency quadrupled Nd:YAG lasers on samples of porcine LF. The objective was to evaluate the suitability of these lasers for surgical removal of LF.Study Design/Materials and MethodsLF was resected from porcine spine within 2 hours of sacrifice and stored in saline until immediately prior to laser irradiation, which occurred within an additional 2 hours. The optical absorbance of a sample was measured over the spectral band from 190 to 2,360 nm both before and after dehydration. For the experiments using the Ho:YAG (λ = 2,080 nm, t p = 140 µs, FWHM) and Q‐Switched Ho:YAG (λ = 2,080 nm, t p = 260 ns, FWHM) lasers, energy was delivered to the LF through a laser‐fiber optic with 600 µm core and NA = 0.39. For the experiment using the frequency quadrupled Nd:YAG laser (λ = 266 nm, t p = 5 ns FWHM), rather than applying the laser energy through a laser‐fiber, the energy was focused through an aperture and lens directly onto the LF. Five experiments were conducted to evaluate the effect of the given lasers on LF. First, using the Ho:YAG laser, the single‐pulse laser‐hole depth versus laser fluence was measured with the laser‐fiber in direct contact with the LF (1 g force) and with a standoff distance of 1 mm between the laser‐fiber face and the LF. Second, with the LF remaining in situ and the spine bisected along the coronal plane, the surface temperature of the LF was measured with an IR camera during irradiation with the Ho:YAG laser, with and without constant saline flush. Third, the mass loss was measured over the course of 450 Ho:YAG pulses. Fourth, hole depth and temperature were measured over 30 pulses of fixed fluence from the Ho:YAG and Q‐Switched Ho:YAG lasers. Fifth, the ablation rate and surface temperature were measured as a function of fluence from the Nd:YAG laser. Several LF staining and hole‐depth measurement techniques were also explored.ResultsAside from the expected absorbance peaks corresponding to the water in the LF, the most significant peaks in absorbance were located in the spectral band from 190 to 290 nm and persisted after the tissue was dehydrated. In the first experiment, using the Ho:YAG laser and with the laser‐fiber in direct contact with the LF, the lowest single‐pulse fluence for which LF was visibly removed was 35 J/cm2. Testing was conducted at 6 fluences between 35 and 354 J/cm2. Over this range the single‐pulse hole de...

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“…Laser-based minimally invasive therapies have already been used for various indications in urology, spine surgery, ear, nose and throat surgery, proctology, and phlebology [7][8][9][10][11][12]. Mounting data in these fields suggest a reduction of surgery-associated comorbidities, as well as optimization of many relevant clinical aspects in comparison to conventional techniques that favor lasers in minimally invasive procedures [7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

First experiences with a diode laser in major gynecological laparoscopic procedures show lack of benefit and impaired feasibility

et al. 2023

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Purpose The aim of this study is to evaluate feasibility and potential benefit of a diode laser in major laparoscopic procedures in gynecology. Methods Between 2018 and 2020, a total of 42 cases were enrolled in this study comparing standard electrosurgery with diode laser-supported therapy in laparoscopic supracervical hysterectomy (LASH), total laparoscopic hysterectomy (TLH), or laparoscopic myoma enucleation (LME). Dual wavelength 45 W diode laser light was used to cut and coagulate during laparoscopy in the prospective interventional arm consisting of 11 cases, while 31 matching patients who received conventional treatment with monopolar/bipolar current for the same interventions were retrospectively identified in our laparoscopy database. Recruitment in the prospective interventional laser diode arm was terminated after only 11 patients (instead of planned 50) due to intense hemorrhage and massive smoke development. Results A total of 42 cases were analyzed (11 LME, 19 LASH, and 12 TLH). Strong smoke development was evident in all 11 cases in the diode laser arm. It was necessary to convert to bipolar or monopolar current in all hysterectomies (n = 9) with initial diode laser implementation due to increased bleeding and smoke development. Conventional current sources had to be used in LMEs (n = 2) due to excessive bleeding and poor visibility during enucleation of the fibroid. A significant difference (p < 0.0001) was observed regarding smoke development when comparing the laser arm with the control arm. Conclusion We found a 45-W diode laser to be inferior to electrosurgical techniques for major laparoscopic gynecologic surgeries regarding bleeding control and smoke development.

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Efficacy of percutaneous laser disc decompression on lumbar spinal stenosis

Cited by 8 publications

References 12 publications

Comparison of the ablation ability of nucleus pulposus after 1,064 nm Nd:YAG laser and 980 nm diode laser radiation

Comparison of the ablation ability of nucleus pulposus after 1,064 nm Nd:YAG laser and 980 nm diode laser radiation

Ablation of porcine ligamentum flavum with Ho:YAG, q‐switched Ho:YAG, and quadrupled Nd:YAG lasers

First experiences with a diode laser in major gynecological laparoscopic procedures show lack of benefit and impaired feasibility

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