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Comparative outcome of Holmium: YAG and KTP laser disc ablation in degenerative cervical disc disease: results of an ongoing study

Objective. This prospective study was designer to identify the relative efficacy of Holmium2100: YAG and KTP532 laser wavelengths in the treatment of broad based cervical disc protrusions presenting with cervical axial pain with compressive or non compressive radicular symptoms.
Methods. Patients with chronic cervical pain and radicular symptoms unresponsive to conservative treatment were assessed with MR scans. Those with broad based disc bulges were assessed with provocative discography to isolate the source of pain. Percutaneous laser disc decompression was performad as a day case procedure on 105 patients at 108 levels under X-ray control via the anterior approach with side firing probes. Vernon-Mior cervical disability and visual analogue pain indices were used to assess the outcome of the procedures.
Results. At a minimum follow up of 12 months 50% of patients demonstrated a sustained significant (excellent to good) clinical benefit with an index value of 50% or more while an additional 25% demonstrated functional improvement. No difference in outcome was identified with either wavelength utilized or with laser annealing or painful discal tears. At this juncture the cohort integrity of the study is 74%.
Conclusion. The outcome of treatment for cervical degenerative disc disease with compressive or non compressive radicular symptoms with KTP or Holmium: YAG laser is identical. The sustained nature of the benefit after long term preoperative symptoms (mean 3,4 years) rules out placebo effect

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