Potential Operative Complications of Percutaneous Laser Discectomy

  • J. A. Botsford

Abstract

Percutaneous laser discectomy (PLD) is a safe and effective alternative treatment of the symptomatic contained lumbar disc herniation. Its success depends on appropriate patient selection and careful attention to operative technique. Several articles dealing with the radiology of patient selection have been published [1–3]. Others have discussed the basic surgical prinicples of the percutaneous approach to the lumbar intervertebral disc [4–7]. When rigid preoperative selection criteria are applied and careful operative technique is used, treatment failure is usually related to potentially avoidable operative complications. The number-one axiom in PLD is “laser not in disc, disc not lased.”

Keywords

Lumbar Disc Herniation Herniate Nucleus Pulposis Percutaneous Laser Recurrent Disc Herniation Thermal Trauma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. [1]
    Botsford JA (1993) Radiological considerations: percutaneous laser disc decompression. J Clin Laser Med Surg 11 (5):229–231Google Scholar
  2. [2]
    Botsford JA (1994) Radiological consideration: patient selection for percutaneous laser disc decompression. J Clin Laser Med Surg 12(5):255–259PubMedGoogle Scholar
  3. [3]
    Botsford JA (1994) CT discography: prognostic value in patient selection for percutaneous laser disc decompression (PLDD). In: 94th annual meeting of the American Roentgen Ray Society (ARRS), New Orleans, LA, April 2 and 29, 1994; Abstract no 265Google Scholar
  4. [4]
    Choy DSJ, Ascher PW, Saddekni S, Alkaltis D, Liebler M, Hughes J, Diwan S, Altman P (1992) Percutaneous laser disc decompression. Spine 17:949–956PubMedCrossRefGoogle Scholar
  5. [5]
    Hijikata S, Yamagishi M, Nakayama T, Oomori K (1975) Percutaneous discectomy: a new treatment for lumbar disc herniation. J Toden Hosp 5:5–13Google Scholar
  6. [6]
    Choy DSJ (1994) The problem of the L5-S1 disc solved by needle entry with an extrathecal approach. J Clin Laser Med Surg 12(6):321–324PubMedGoogle Scholar
  7. [7]
    Botsford JA (1995) The role of radiology in percutaneous laser disc decompression. Clin Laser Med Surg 13(3): 173–186Google Scholar
  8. [8]
    Hueftle MG, Modic MT, Ross JS, Masaryk TJ, Carter JR, Wilbur G, Bohlman H (1988) Lumbar spine: postoperative MR imaging with Gd-DTPA. Radiology 167:817–824PubMedGoogle Scholar
  9. [9]
    Ross JS, Delamarter R, Hueftle MG, Masaryk TJ, Alkawa M, Carter JR, VanDyke C, Modic MT (1989) Gadolinium-DTPA enhanced MR imaging of the postoperative lumbar spine: time course and mechanism of enhancement. AJNR 10:37–46Google Scholar
  10. [10]
    Georgy BA, Hesselink JR (1992) Gadolinium-enhanced fat suppression MR imaging of the postoperative back. In: 78th scientific assembly and meeting of the Radiological Society of North Amerikca (RSNA), Chicago, Illinois, November 29 to December 4, 1992; Abstract no 303Google Scholar
  11. [11]
    Soropoulos S, Chafetz NI, Lang P, Winkler M, Morris JM, Weinstein PR, Genant HK (1989) Differentiation between postoperative scar and recurrent disc herniation: prospective comparison of MR, CT, and contrast enhanced VCT. AJNR 10:639–643Google Scholar
  12. [12]
    Bundschuh CV, Modic MT, Ross JS, Masaryk TJ, Bohiman H (1988) Epidural fibrosis and recurrent disc herniation in the lumbar spine: MR imaging assessment. AJNR 9:169–178Google Scholar
  13. [13]
    Boden SD, Davis DO, Dina TS, Parker CP, O’Malley S, Sunner JL, Wiesel SW (1992) Contrast enhanced MR imaging performed after successful lumbar disc surgery: prospective study. Radiology 182:59–64PubMedGoogle Scholar
  14. [14]
    Dina TS, Boden SD, David DO (1995) Lumbar spine after surgery for herniated disc: imaging findings in the early postoperative period. AJR 164:665–671PubMedCrossRefGoogle Scholar
  15. [15]
    Brock M, Gorge H, Curio G (1984) Intradiscal pressure volume response: A methodological contribution to chemonucleolysis. J Neurosurg 60:1029–1032PubMedCrossRefGoogle Scholar
  16. [16]
    Choy DSJ, Altman P (1993) Fall of intradiscal pressure with laser ablation. Spine: State of the art reviews 7(1):23–29Google Scholar
  17. [17]
    Bernard TN (1990) Lumbar discography followed by computed tomography. Spine 15:690–707PubMedCrossRefGoogle Scholar
  18. [18]
    Collis JS Jr, Gardner WJ (1962) Lumbar discography: an analysis of one thousand cases: J Neurosurg 19:452–461PubMedCrossRefGoogle Scholar
  19. [19]
    Boden SD, David DO, Dina TS, Sunner JL, Wiesel SW (1992) Postoperative discitis: distinguishing early MR imaging findings from normal postoperative disc-space changes. Radiology 184:767–771Google Scholar
  20. [20]
    Gundry CR, Heithoff KB (1993) Epidural hematoma of the lumbar spine: 18 surgically confirmed cases. Radiology 187:427–431PubMedGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 2001

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  • J. A. Botsford

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