Percutaneous Laser Disc Decompression (PLDD)

Pain caused by a herniated disc can result from sports injuries or daily activities such as prolonged sitting or heavy lifting. This condition often causes worry and disrupts the daily lives of many people. Treatment for a herniated disc varies from medication and physical therapy to injections, depending on the severity of the condition.

Today, we would like to introduce a treatment called Percutaneous Laser Disc Decompression (PLDD), which is suitable for patients with a herniated disc pressing on a nerve who have not improved with medication and physical therapy but do not yet require surgery. These patients do not show symptoms of muscle weakness, have no problems with walking control, and can control their bladder or bowel movements normally.

What is Percutaneous Laser Disc Decompression or PLDD?
PLDD is a minimally invasive treatment for herniated discs. The method involves using an optic fiber to deliver a laser to the level of the herniated disc to achieve the following:

1. Vaporization: The disc material is vaporized.
2. Hardening: The disc material is hardened.
3. Denervation: The nerve's pain signals are interrupted.

When these three events occur, the herniated disc will contract, reducing the pressure within the disc. This reduction in pressure alleviates the compression on the nerve, leading to an improvement in the radiating pain along the nerve.

What are the advantages of PLDD treatment?

1. Minimal tissue injury: There is no cutting of muscles as the incision is the size of a needle hole.
2. No scar formation: There are no scars that could become problematic later on.
3. No hospital stay required: Patients are observed for a short period and can go home if no abnormalities are found.
4. No general anesthesia needed: Local anesthesia is sufficient for the procedure.
5. Quick recovery: Since it is not a major surgery, patients recover quickly.
6. More affordable than surgery: The cost is lower compared to surgical procedures.
 

Steps for Performing PLDD

1. The patient receives antibiotics to prevent infection during the procedure.
2. The patient is positioned face down.
3. The staff cleans the area where the procedure will be performed and prepares sterile equipment.
4. The doctor administers local anesthesia to reduce pain in the targeted area.
5. The doctor uses an optic fiber (the size of an injection needle) to target the herniated disc with the laser.
6. The position of the needle is verified using a C-arm and ultrasound machine.
7. The patient rests in the recovery room for 1-2 hours to monitor for any abnormalities. If no issues arise, the patient can go home.
 

An example of performing PLDD in the operating room.

Post-Procedure Care after PLDD

1. Wear a lumbar brace for 3-4 weeks.
2. Avoid sitting or standing for longer than 1 hour continuously.
3. Avoid sports and heavy lifting for 6 weeks after the procedure.
4. Avoid driving for 4 weeks after the procedure.
5. You can take NSAID pain relievers if you experience soreness.

Please note that the procedures, methods, and results may vary from person to person. You can schedule a consultation at Vasu Pain Management before undergoing the procedure.

Referenced from the article by G. Kienbacher, PLDD Training Center Graz, Austria.