Abstract

PURPOSE: The purpose of this study was the evaluation of advantages in the procedure of percutaneous laser disk decompression in the treatment of lumbar disk herniation in comparison to open surgical methods on lumbar disk herniation like microdisectomy. Having access to the worlds neurosurgery literature we have found out that the percutaneous laser disk decompression is becoming an appropriate substitute for microdisectomy in surgical treatments of patients in cases of lumbar disk herniation. MATERIAL OR SUBJECTS: From June 2008 till July 2009 in the Clinical hospital Sister of Mercy Zagreb 155 patients have been treated with percutaneous laser disk decompression and 125 patients have been treated with microdisectomy. Outcome Measures: we try to represent our experiences and results, which we have achieved by treating patients with lumbar disk herniation with PLDD procedures in contrast to patients treated with microdisectomy. Methods: The percutaneous laser disk decompression is done with the usage of a diode laser (LASE maR 1000), intensity of 1600 j, power 12 W and wave length 980 nm. Open surgical methods for lumbar disk herniation are performed with the surgical technique microdisectomy. The input and output criteria were the same for both groups of patients. The data achieved with the analyses of input and output parameters have been compared with the help of the MacNab criteria. There have not been found any statistically significant results in the comparison of data for age, sex and the stage of intervertebral disk herniation in both groups. This is a retrospective research and lasted 12 months. RESULTS: Patients treated with the percutaneous laser disk decompression had in 89, 6 % ( n=139) very good or excellent results and were satisfied with the success of the treatment. In the group of patients treated with microdisectomy the number of patients, which had very good or excellent results, is minor and numbers 81, 2% (n=101). Postsurgical complications appeared in 1,2% ( n=2) in the group of patiens operated with percutaneous laser disk decompression. One patient had another percutaneous laser disk decompression and another patient had a METRx interlaminectomy. In the group of patients treated with microdisectomy, the number of patients, where complications appeared, is higher and numbers 6, 5% (n=8). CONCLUSION: The percutaneous laser disk herniation is a safer, simple and more effective method in treating patients with lumbar disk herniation in relation to open methods of treating lumbar disk herniation like microdisectomy.