percutaneous laser nucleotomy for lumbar disc herniation: Preliminary report of early results and MRI findings

Early therapeutic results and magnetic resonance imaging (MRI) findings were serially evaluated for 34 consecutive patients with lumbar disc herniation treated by percutaneous laser nucleotomy (PLN), a minimally invasive technique for reducing intradiscal pressure, in which a neodymium: yttrium-aluminum-garnet (Nd:YAG) laser was used. At the mean follow up 13.8 months after PLN, successful results were obtained in 20 patients (58.8%). No serious complications were encountered. In patients with contained discherniation, the improvement rate was significantly higher than that in patients with non-contained dise herniation (P<0.05). Sagittal magnetic resonance (MR) images obtained during the time sequence after PLN demonstrated a relationship between MR signal intensity patterns and clinical recovery. No measurable change in the size of the herniated mass was confirmed on axial images immediately after PLN, while, in contrast, reduced signal intensity inside the disc was observed in 12 of 20 patients with successful results in the early postoperative period. Postoperative T2-weighted MRI can be used to predict the prognosis of patients treated with PLN. This work was presented, in part, at the 68th Annual Meeting of the Japanese Orthopaedic Association, Yokohama, 9–11 April, 1995