A narrative review of percutaneous laser disc decompression - early experience in Lagos, Nigeria

Abstract

Overview. Managing chronic pain arising from the degenerative disc disease of the spine has remained a huge challenge while choosing from within a vast array of treatment armamentum ranging from the use of medications only or in combination with other physical treatment options, minimally invasive heat therapy, and operative interventions. Patients with chronic pain referred to as ‘contained disc’ in cervical, thoracic, and lumbar disc pathology have been successfully managed with percutaneous laser disc ablative therapy. This approach is only for selected patients and advantages derivable from this approach are the preservation of soft tissue anatomy, minimal post-procedure pain, less metabolic responses, and no blood loss when compared to open surgical procedures. Methodology. This is a one-year retrospective narrative study of six adult patients who presented with chronic low back pain related to the spine and had a lumbosacral spine magnetic resonance imaging (MRI) scan with findings of contained disc herniation. Patients’ brief clinical evaluation which involves biodata, history of pain, and pain scores using the visual analogue scale (VAS) pre and post-intervention and Oswestry disability index to assess disability from chronic pain. A narration of these patient’s progression to follow-up six months after the procedure was documented. Results. The results showed significant improvement in the VAS and ODI scores in five of the 6 patients, with one showing marginal improvement. Conclusion. Percutaneous lumbar disc decompression is effective in the management of chronic low back with concordant clinical and radiological evidence of contained disc pathology.

Keywords

• chronic pain
• contained disc
• laser
• percutaneous
• decompression