Effect of the 1064-nm Nd-YAG Laser on Lumbar Intervertebral Disc Tissue: Experimental Study for Assessing the Operation Concept

  • E. Lensker
  • P. Simons
  • K. von Wild
  • H. P. Hobik
  • R. R. Lehmann
Conference paper
Part of the Advances in Neurosurgery book series (NEURO, volume 22)


Increasing importance is being given to minimally invasive, percutaneous methods in the treatment of patients with therapy-resistant lumboischialgiae [8]. Using the dorsolateral approach, various procedures have been developed to decompress the affected nerve root. While chemonucleolysis decomposes the intervertebral disc tissue by a chondrolytic enzyme, other methods reduce the disc volume mechanically by forceps or automated probes. In 1986 Ascher was the first to use laser radiation clinically to decompress intervertebral discs [4]. Good results have been reported although various types of lasers and parameters are in use [1, 4, 9–11]. Nevertheless, there are considerable discrepancies in the conception of this method. Does the mechanism work on thermally achieved volume reduction only or must additive effects also be taken into account? Even the problem of serious complications that may arise has not yet been finally answered [6]. We considered these questions on the basis of our hospital-specific method in an experimental study.


Intervertebral Disc Laser Fiber Nucleus Pulposus Annulus Fibrosus Intradiscal Pressure 
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.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Berlien H-P, Müller G (1989) Angewandte Lasermedizin. Lehr und Handbuch für Praxis und Klinik. Ecomed, LandsbergGoogle Scholar
  2. 2.
    Brinckmann P, Grottenboer H (1991) Change of disc height, radial disc bulge, and intradiscal pressure from discectomy. An in vitro investigation on human lumbar discs. Spine 16(6):641–646PubMedCrossRefGoogle Scholar
  3. 3.
    Choy DSJ, Altman PA, Case RB, Trokel SL (1991) Laser radiation at various wavelength for decompression of intervertebral disk. Experimental observations on human autopsy specimens. Clin Orthop 267(6):245–250PubMedGoogle Scholar
  4. 4.
    Choy DSJ, Ascher PW, Saddekni S, Alkaitis D, Liebler W, Hughes J, Diwan S, Altman P (1992) Percutaneous laser disc decompression. A new therapeutic modality. Spine 17(8):949–956PubMedCrossRefGoogle Scholar
  5. 5.
    Humzah MD, Soames RW (1988) Human intervertebral disc: structure and function. Anat Rec 220:337–356PubMedCrossRefGoogle Scholar
  6. 6.
    Kambin P (1991) Laser nuclear ablation. In: Kambin P (ed) Arthroscopic microdiscectomy. Minimal intervention in spinal surgery. Urban and Schwarzenberg, Munich, pp 133–136Google Scholar
  7. 7.
    Lehmann RR, Willital GH (1990) Morphological alterations following laser resection of abdominal tumors in children. Lasermedizin 0:25–35Google Scholar
  8. 8.
    Mayer HM, Brock M (1988) Behandlung des lumbalen Bandscheibenvorfalls. Die perkutane Diskektomie. Dtsch Arztebl 85(13):853–858Google Scholar
  9. 9.
    Mayer HM, Brock M, Berlien H-P, Weber B (1992) Percutaneous endoscopic laser discectomy (PELD). A new surgical technique for nonsequestrated lumbar discs. Acta Neurochir Suppl (Wien) 54:53–58CrossRefGoogle Scholar
  10. 10.
    Philandrianos G, Rose C, Siebert WE (1991) Behandlung des Bandscheibenvorfalls mit dem Laser. In: Siebert WE, Wirth CJ (eds) Laser in der Orthopädie. Einsatzmöglichkeiten der Lasertechnik bei operativen und diagnostischen Verfahren am Bewegungsapparat. Thieme, Stuttgart, New YorkGoogle Scholar
  11. 11.
    Siebert WE, Bise K, Breitner S, Fritsch K, Wirth CJ (1988) Die Nucleus-pulposus-Vaporisation — eine neue Technik zur Behandlung des Bandscheibenvorfalls? Orthop Prax 24(12):732–735Google Scholar
  12. 12.
    Siebert W (1993) Percutaneous laser disc decompression: the European experience. Spine State Art Rev 7(1):103–133Google Scholar
  13. 13.
    Spencer DL, Miller JAA, Bertolini JE (1984) The effect of intervertebral disc space narrowing on the contact force between the nerve root and a simulated disc protrusion. Spine 9(4):422–426PubMedCrossRefGoogle Scholar
  14. 14.
    Vorwerk D, Husemann T, Blazek V, Zolotas G, Günther RW (1989) Laserablation des Nucleus pulposus: optische Eigenschaften von degeneriertem Bandscheibengewebe im Wellenlängenbereich von 200 bis 2200 nm. Fortschr Rontgenstr 151(6):725–728CrossRefGoogle Scholar
  15. 15.
    Yonezawa T, Tanaka S, Watanabe H, Onomura T, Atsumi K (1989) Percutaneous intra-discal laser discectomy. In: Mayer HM, Brock M (eds) Percutaneous lumbar discectomy. Springer, Berlin Heidelberg New York, pp 197–204Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1994

Authors and Affiliations

  • E. Lensker
    • 1
  • P. Simons
    • 1
  • K. von Wild
    • 1
  • H. P. Hobik
    • 2
  • R. R. Lehmann
    • 3
  1. 1.Abt. NeurochirurgieClemenshospitalMünsterGermany
  2. 2.Institut für PathologieClemenshospitalMünsterGermany
  3. 3.Institut für AnatomieWestfälischen Wilhelms-Universität MünsterMünsterGermany

Personalised recommendations