Neurosurgery

The treatment is intended especially for patients suffering from problems with intervertebral discs accompanied by the following symptoms:

• Severe pain in the legs, arms, neck, or lower back.
• Pain that is not relieved after six weeks of conservative treatment (rest, medication or physical therapy).
• Hernia of lumbar discs confirmed by tests (including magnetic resonance imaging, computed tomography, myelography, discography).

The PLDD procedure is performed on an outpatient basis with the use of local anesthesia only. During the procedure, a thin 18 / 20G needle is inserted into the herniated disc under the control of a C-arm X-ray machine or computed tomography. The 400/600 micron diameter fiber is inserted through the needle and the laser energy transmitted through the fiber causes a small fragment of the pulmonary nucleus to evaporate. This creates a temporary negative pressure that draws the hernia away from the nerve root, relieving the pain. The effect is usually immediate.

1. Make the Extend Leg Elevation test and note the amount of elevation.

2. Place the patient in the supine position on the CT table.

3. Establish the injection sites and routes with the use of computed tomography.

4.Perform sterilization and local anesthesia.

5.Insert the 18G needle about 8 cm in the centerline towards the center of the disc. Check that the needle is in the correct position by performing a CT scan.

6.Remove the stylet of the needle, then insert the 400 μm optical fiber. Extend the end of the fiber about 3-5 mm, then connect the Y-rotating connector.

7. Turn on the power, select the operating parameters on the screen and start the laser.

8.Laser energy causes the herniation of the intervertebral disc to evaporate, and then to lower the intrasidial pressure. During the procedure, when the patient experiences swelling or pain, use the Y valve to draw the lymph.