Nucleus Pulposus Vaporization — Experimental Investigations on Use of Lasers on the Intervertebral Disc

Abstract

Use of lasers is already widespread in extensive fields of surgical medicine, in particular owing to its great safety and exact controllability, but also because of the possibility of bringing high energy to the site of action with minimal instruments [16]. The idea of using a laser for treatment of a nonsequestrated intervertebral disc prolapse was logical because of the properties mentioned above. The search for a less invasive method of treatment which hardly burdens the patient for the often very painful protrusion, especially in the region of the lumbar spine, has become important not least in view of studies which criticize the effectiveness of chemonucleolysis [9,11]. The fundamental idea of “nucleus pulposus vaporization” was to reduce by direct vaporization the optically very homogeneous properties of the nucleus pulposus, which differ substantially from the annulus fibrosus at least in healthy persons, and thus to attain decompression in the intervertebral disc concerned. At the same time, it was hoped that this technique would disturb the stability of the movement segments as little as possible owing to the small operation and the selective technique [2, 3, 6].