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Preliminary experience with percutaneous laser disc decompression in the treatment of sciatica

OBJECTIVE: To examine the usefulness of percutaneous laser decompression of a herniated lumbar intervertebral disc. DESIGN: A case series. SETTING: A university-affiliated hospital. PATIENTS: Sixteen patients with clinical and radiologic evidence of herniated lumbar intervertebral discs. INTERVENTIONS: Percutaneous introduction of a fine optical fibre into a herniated lumbar disc and delivery of short pulses of laser energy. MAIN OUTCOME MEASURE: The relief of intractable leg pain. RESULTS: Nine of 14 patients with intractable leg pain experienced total relief after percutaneous laser disc decompression. Four patients required subsequent microsurgical discectomy, and one required a decompressive laminectomy. Of the two patients who had back pain as their major complaint, one required microsurgical discectomy after laser disc decompression. CONCLUSIONS: Percutaneous laser disc decompression can relieve sciatica caused by a herniated intervertebral disc. The technique requires limited use of health resources. Preliminary results suggest that an early return to work can be expected in patients successfully relieved of their leg pain

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