Efficacy evaluation of percutaneous laser disc decompression in the treatment of lumbar disc herniation.

Objective: The purpose of this study was to evaluate the efficacy of percutaneous laser disc decompression (PLDD) in the treatment of lumbar disc herniation (LDH) and identify the relationship between PLDD efficacy and age.

Background Data: Many articles have shown that the short-term clinical outcome of PLDD was fairly good. However, the continuous follow-up results over 3 years of PLDD for LDH treatment are rarely reported, and little is known about the relationship between PLDD efficacy and age.

Methods: Forty-two LDH patients who had undergone PLDD with an Nd:YAG laser from July 2003 to August 2007, were divided into two groups according to age, with 19 cases in the ≤45-year-old age group and 23 cases in the >45-year-old group. All the patients were evaluated with the Japanese Orthopaedic Association (JOA) Scores before and after the PLDD to calculate the improvement rate of lumbar JOA scores, according to which the follow-up results were graded as excellent, good, fair, or poor.

Results: Eighty affected discs in 42 patients were treated successfully with no complications in this study. The favorable outcomes of the 42 patients at 1-, 3-, 6-, 12-, 24-, and 36-month follow-up were separately 45.24%, 66.67%, 71.43%, 76.19%, 80.95%, and 76.19%. The favorable outcome significantly improved from 45.24% at 1-month follow-up to 66.67% at 3-month (p<0.05). There was no significant difference of favorable outcome at 3-, 6-, 12-, 24-, and 36-month follow-up (p>0.05).The preoperative lumbar JOA scores in two groups was not different (p>0.05), and no between-group differences were noted in favorable outcome at the same follow-up time (p>0.05).

Conclusions: The clinical outcome of PLDD improved significantly within 3 months, and can maintain a higher level in 3 years. The efficacy of treatment with PLDD is fairly good for both selected younger and older patients.