Diode laser for Percutaneous Laser Disc Decompresion (PLDD)
The Diode laser is indicated for Percutaneous Laser Disc Decompresion (PLDD), for treatment of back pain resulting from herniated discs.
The treatment principle of PLDD is based on the concept of the intervertebral disk being a closed hydraulic system. This system consists of the nucleus pulposus, containing a large amount of water, surrounded by the inelastic annulus fibrosus. An increase in water content of the nucleus pulposus leads to a disproportional increase of intradiskal pressure. A reduction of intradiskal pressure causes the herniated disk material to recede toward the center of the disk, thus leading to reduction of nerve root compression and relief of radicular pain. In PLDD, this mechanism is exploited by application of laser energy to evaporate water in the nucleus pulposus.
Laser energy is delivered by a laser fiber through a hollow needle placed into the nucleus pulposus. The needle is placed into the intervertebral disk under local anesthesia. Apart from evaporation of water, the increase in temperature also causes protein denaturation and subsequent renaturation. This causes a structural change of the nucleus pulposus, limiting its capability to attract water andtherefore leading to a permanent reduction of intradiskal pressure.
The treatment principle of PLDD is based on the concept of the intervertebral disk being a closed hydraulic system. This system consists of the nucleus pulposus, containing a large amount of water, surrounded by the inelastic annulus fibrosus. An increase in water content of the nucleus pulposus leads to a disproportional increase of intradiskal pressure. A reduction of intradiskal pressure causes the herniated disk material to recede toward the center of the disk, thus leading to reduction of nerve root compression and relief of radicular pain. In PLDD, this mechanism is exploited by application of laser energy to evaporate water in the nucleus pulposus.
Laser energy is delivered by a laser fiber through a hollow needle placed into the nucleus pulposus. The needle is placed into the intervertebral disk under local anesthesia. Apart from evaporation of water, the increase in temperature also causes protein denaturation and subsequent renaturation. This causes a structural change of the nucleus pulposus, limiting its capability to attract water andtherefore leading to a permanent reduction of intradiskal pressure.
