Introduction: PLDD (Percutaneous laser disk decompression) is a safe, non-destructive and successful surgical treatment for lumbar disk herniation. 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.
Patients: From June 2008 till July 2009 in the Clinical hospital “Sister of Mercy” Zagreb 91 patients have been treated with percutaneous laser disk decompression and 125 patients have been treated with microdisectomy.
Methods: The percutaneous laser disk decompression is done with the usage of a diode laser (LASE maR 1000), intensity of 1000 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 criterion for the research was the adulthood of the examinee and advanced herniation of the intervertebral disk in the lumbar spine, which needed surgical treatment. The analysed parameters were: success of the surgical treatment; relapsing lumbar disk herniations; postsurgical complications; postsurgical stay in the hospital; time needed to return to every-day activities. 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=81) 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 2,5% (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 MET-Rx interlaminectomy. In the group of patients treated with microdisectomy, the number of patients, where complications appeared, is higher and numbers 6,5% (n=8). As the research moved on the frequency of percutaneous lumbar disk decompression increased, so that this surgical method has been the most present in the last months of the research, while the presence of the microdisectomy was gradually decreasing.
Conclusion: The results of the conducted research have afirmated the comparative advantages of contemporary surgical methods in treating lumbar disk herniation in reference to classical treating methods.PLDD (Perkutana laser disk dekompresija) siguran je, nedestruktivan i uspješan kirurški zahvat kod lumbalne diskus hernije. Cilj ove studije je bio evaluacija prednosti procedure perkutane laser disk dekompresije u tretmanu lumbalne diskus hernije naspram otvorenih operacijskih metoda slabinske diskus hernije tipa mikrodiskektomije. Od lipnja 2008.god do srpnja 2009 god. u Kliničkoj bolnici Sestara milosrdnica, 91 bolesnik je tretiran uz pomoć perkutane laser disk dekompresije i 125 bolesnika tretiranih uz pomoć mikrodiskektomije. Perkutana laser disk dekompresije sec.Choy je rađena uz uporabu diodnog lasera (LASE maR 1000) jačine 1000 j, snage 12 W i valne duljine 980 nm. Kriterij uključivanja u istraživanje bio je odrasla životna dob ispitanika i uznapredovala hernijacija intervertebralne ploče slabinske kralježnice, koja je zahtijevala kirurško liječenje. Analizirani izlazni parametri bili su: uspješnost operacijskoga liječenja; recidivirajuće slabinskie diskus hernije; poslijeoperacijske komplikacije; dužina poslijeoperacijskoga boravka u bolnici; vrijeme potrebito za povratak svakodnevnim aktivnostima. Podatke dobivene analizom ulaznih i izlaznih parametara smo uspoređivali uz pomoć Macnab kriterija. Usporedbom podataka za dob, spol, razinu hernijacije intervertebralne ploče u obje skupine bolesnika nisu nađeni statistički značajni rezultati. Ovo je retrospektivno istraživanje u trajanju od 12 mjeseci. Bolesnici kojim je urađena perkutana laser disk dekompresija su u 89,6% imali dobre ili odlične rezultate i bili su zadovoljni uspjehom liječenja. U skupini bolesnika tretiranih uz pomoć mikrodiskektomije broj bolesnika koji su imali dobre ili odlične rezultate nakon operacijskog zahvata i bili zadovoljni uspjehom istog je manji i iznosi 81,2%. Poslijeoperacijske komplikacije su se pojavile kod 2,5% boelsnika operiranih perkutanom laser disk dekompresijom. Od toga je jedan bolesnik ponovno operiran perkutanom laser disk dekompresijom a drugi uz pomoć METRx interlaminektomije. Broj bolesnika sa komplikacijama kod kojih je rađena mikrodiskektomija je znatno veći i iznosi 6,5%. Kako je istraživanje odmicalo učestalost se perkutane lumbalne dekompresije diska povećavala, tako da je ova operacijska metoda bile najzastupljenija u zadnjim mjesecima istraživanja, dok se učestalost mikrodiskektomije postupno smanjivala. Rezultati provedenoga istraživanja afirmirali su komparativne prednosti suvremenih operacijskih metoda liječenja slabinske diskus hernije u odnosu na klasične metode liječenja
