Laser discectomy, often referred to by the term percutaneous laser disc decompression or the PLDD procedure, is a minimally invasive technique used to treat certain contained disc herniations that are contributing to back or radicular leg pain. Performed through a needle rather than an open incision, it represents one option within the broader category of percutaneous disc decompression techniques used when conservative treatment has not adequately resolved symptoms.
What Type of Disc Herniation Is Suitable for This Approach?
Laser discectomy is generally considered for contained disc herniations, meaning the herniated disc material remains within the outer fibrous ring of the disc rather than having fully extruded into the spinal canal. This distinction matters because the procedure works by reducing internal disc pressure, which is most effective when the outer disc wall is still intact enough to respond to that pressure reduction. Larger, extruded, or sequestered disc fragments, where material has broken free into the spinal canal, are generally not considered good candidates for this technique and often require a different surgical approach.
How Does the PLDD Procedure Work?
During the PLDD procedure, a thin needle is advanced into the center of the affected disc under fluoroscopic (X-ray) guidance, typically using local anesthesia with the patient awake or lightly sedated. A laser fiber is then passed through the needle, and controlled laser energy is applied to vaporize a small portion of the gel-like nucleus material inside the disc. This disc vaporization reduces the overall volume and internal pressure of the disc, which in turn is intended to reduce the outward pressure the herniated portion places on the adjacent nerve root, thereby reducing the associated pain and inflammation.
Why Is This Often Called a Day-Case Spine Procedure?
Because laser discectomy is performed percutaneously, through a needle rather than an open surgical incision, and typically uses local anesthesia with minimal sedation, it is often performed as day-case spine care, meaning patients go home the same day rather than requiring an overnight hospital stay. Recovery timelines vary among patients, but many report a gradual reduction in radicular symptoms over the days to weeks following the procedure, as the reduced disc pressure allows inflammation around the affected nerve root to settle.
How Does This Compare With Other Decompression Methods?
Laser discectomy is one of several percutaneous disc decompression techniques, which also include mechanical and radiofrequency-based nucleoplasty methods that reduce disc pressure through different mechanisms rather than laser vaporization. Each technique shares the same underlying goal, reducing pressure within a contained herniated disc, but the specific technology and instrumentation differ. The choice among these approaches depends on the treating physician's assessment of the specific disc pathology, available equipment, and clinical judgment, since no single decompression technique is considered universally superior for every contained herniation.
An INVAMED Device Used in Laser Discectomy
INVAMED manufactures the Spark Laser Discectomy Device, used in percutaneous laser disc decompression procedures for suitable contained disc herniations. As with any percutaneous disc procedure, careful patient selection based on imaging characteristics of the herniation is central to appropriate use, and a qualified physician determines whether laser discectomy or an alternative approach is suitable for an individual patient's disc pathology. Availability and indications vary by country, and clinicians should refer to the official Instructions for Use for complete information.
Does laser discectomy remove the entire herniated disc?
No, the procedure vaporizes only a small portion of the internal nucleus material to reduce overall disc pressure rather than removing the herniated portion directly. The goal is pressure reduction around the affected nerve root rather than physical extraction of the herniated fragment.
Device availability and regulatory status vary by country. Please contact INVAMED or your authorized local distributor for current regulatory information applicable to your region.