ArticleLasers in medical science2025
MRI changes and clinical results of low energy semiconductor percutaneous laser disc decompression(LS-PLDD) for lumbar disc herniation in adolescents.
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Abstract
Low-energy semiconductor percutaneous laser disc decompression (LS-PLDD) is a minimally invasive technique that employs laser energy to treat lumbar disc herniation (LDH). To date, no clinical studies have evaluated its efficacy in adolescent patients. This study aimed to assess the safety and effectiveness of LS-PLDD compared with percutaneous endoscopic lumbar discectomy (PELD) in the management of adolescent LDH. Collected data on 30 adolescent LDH patients who underwent LS-PLDD, and 60 adolescent LDH patients who underwent PELD, matched for age and sex. Lumbar ODI scores and back pain VAS scores were recorded preoperatively and at 1 week, 1 month, 3 months, and 6 months postoperatively to evaluate clinical outcomes in the two groups. In addition, lumbar MRI scans obtained preoperatively and at 3 months postoperatively were compared to assess disc changes. The preoperative back VAS scores were (7.0 ± 0.91) and (7 ± 0.8) in the LS-PLDD group and PELD group respectively, with no significant statistical difference (P = 0.779). The VAS scores of both groups had improvement after surgery. At the last follow-up, the VAS scores of both groups were (2.0 ± 1.3) and (1.0 ± 0.8) respectively ( P < 0.01). The VAS scores of patients in PELD group improved most significantly in the first week after surgery and then gradually stabilized, while that in LS-PLDD group improved more gradually during 6 months after surgery. The preoperative ODI scores of the LS-PLDD group and PELD group were (71.1 ± 7.9)% and (68.0 ± 7.3)% (P = 0.061), at the last follow-up, the ODI scores were (28.0 ± 13.1)% and (19.0 ± 8.4)% (P < 0.01). The preoperative canal cross-sectional areas in the LS-PLDD group and PELD group were (1373.0 ± 376.6) and (1457 ± 415.9) respectively, with no significant difference between the two groups (P = 0.157), at the last follow-up, the canal cross-sectional area of the surgical segments were (1373 ± 476.6) and (1457 ± 579.1) (P = 0.227)respectively. This study shows that low energy semiconductor laser LS-PLDD is a safe and effective treatment method for adolescent LDH. It can achieve sustained retraction of the herniated disc and retain the intact structure of the disc.
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