Percutaneous laser disc decompression (PLDD)
Percutaneous laser disc decompression (PLDD) is a minimally invasive surgical procedure used to treat herniated discs that cause severe lower back pain. This technique is performed through a small incision in the patient's back using a laser probe to vaporize a portion of the nucleus pulposus, the soft inner material of the disc, reducing its size and pressure on the surrounding nerves. Here is a step-by-step description of the PLDD surgical technique.
Step 1: Patient Preparation
The patient is positioned on a surgical table in the prone position, face down. The area of the back where the herniated disc is located is cleaned and sterilized with an antiseptic solution. The surgeon then numbs the area around the affected disc with a local anesthetic.
Step 2: Guide Wire Placement
The surgeon uses X-ray guidance to insert a guide wire into the disc through a small incision in the skin. The wire is inserted into the center of the disc, and its position is verified using X-ray imaging.
Step 3: Laser Fiber Insertion
A laser fiber is then inserted over the guide wire and into the disc. The fiber is threaded through the nucleus pulposus to the outer rim of the disc.
Step 4: Laser Treatment
Once the laser fiber is in place, the surgeon activates the laser, which delivers energy to the nucleus pulposus. The laser vaporizes a portion of the nucleus pulposus, reducing its size and pressure on the surrounding nerves.
Step 5: Fiber Removal
After the laser treatment is completed, the surgeon removes the laser fiber from the disc.
Step 6: Closure
The small incision in the skin is closed with sutures or adhesive strips. The patient is then monitored for a short period of time before being released to go home.
After the procedure, most patients experience significant pain relief and improved mobility within a few weeks. PLDD is a highly effective treatment option for patients with lower back pain caused by herniated discs, with success rates ranging from 70-90%.
In conclusion, percutaneous laser disc decompression (PLDD) is a safe and effective minimally invasive surgical technique for treating herniated discs. The procedure is performed through a small incision in the patient's back using a laser probe to vaporize a portion of the nucleus pulposus. By reducing the size of the herniated disc, the procedure can relieve pain and improve mobility. If you suffer from lower back pain caused by a herniated disc, talk to your doctor about whether PLDD may be a suitable treatment option for you.
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