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Trans-sacral Epiduroscopic Laser Adhesiolysis with Ho:Yag Laser

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Laser Spine Surgery

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Abstract

Lumbar intervertebral disc herniation (LDH) is a clinically symptomatic condition caused by compression of the spinal nerve root by protruded disc material. LDH can be treated with various endoscopic procedures. Recently, trans-sacral epiduroscopic laser decompression (SELD) using epiduroscopy and laser is one of the preferred options for minimally invasive treatment in lumbar disc diseases. Epiduroscopy has been employed because of the smaller diameter of the access portal and the flexible fiber when compared with transforaminal endoscopic lumbar discectomy. It allows treatment of a symptomatic herniated disc that has failed to respond to conservative treatment. SELD showed rapid improvement of back pain and radiculopathy with significant differences in the visual analog scale (VAS) and Oswestry Disability Index (ODI) scores between preoperative and postoperative data in the present study. The advantages of the SELD are direct decompression by laser and targeted mechanical adhesiolysis through direct visualization and very low complication rates. SELD is a safe and effective treatment for lower back and leg pain which arise from a herniated lumbar disc.

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Author information

Authors and Affiliations

  1. Seoul Gimpo Airport Wooridul Spine Hospital, Seoul, Republic of Korea

    Dongho Seo, Ki-Hyoung Moon & Oon-ki Baek

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  1. Dongho Seo
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  2. Ki-Hyoung Moon
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  3. Oon-ki Baek
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Editor information

Editors and Affiliations

  1. President, Department of Neurological Surgery, Wooridul Spine Hospital, Seoul, Korea (Republic of)

    Junseok Bae

  2. Chairman, Wooridul Spine Hospital, Clinical professor of Anatomy, Yonsei University College of medicine, Seoul, Korea (Republic of)

    Sang-Ho Lee

18.1 Electronic Supplementary Material

A 66-year-old woman was presented with chief complaints of right buttock and leg pain. She also had paresthesia on right thigh and posterior calf area. Symptom has developed 6 months ago. The imaging studies showed L4/5 right paracentral disc protrusion. We have performed L4/5 SELD. Initially mechanical adhesiolysis was performed under endoscopic view. After localizing the lesion, the laser was fired (green light indicates laser aim). After surgery, her symptoms have improved without any complications (MP4 235080 kb)

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Seo, D., Moon, KH., Baek, Ok. (2021). Trans-sacral Epiduroscopic Laser Adhesiolysis with Ho:Yag Laser. In: Bae, J., Lee, SH. (eds) Laser Spine Surgery. Springer, Singapore. https://doi.org/10.1007/978-981-16-2206-9_18

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  • DOI: https://doi.org/10.1007/978-981-16-2206-9_18

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-16-2205-2

  • Online ISBN: 978-981-16-2206-9

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