Journal of clinical laser medicine & surgery
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J Clin Laser Med Surg · Feb 2002
Lumbar percutaneous KTP532 wavelength laser disc decompression and disc ablation in the management of discogenic pain.
The objective of this research was to determine the outcome of laser disc decompression and laser disc ablation in the management of painful degenerative disc disease with or without associated disc prolapse. Nonendoscopic percutaneous laser disc decompression was performed under x-ray control via the posterolateral approach with side-firing probes. All patients with chronic back pain who had reproduced pain during discography of a nature, pattern, and distribution similar to what they experienced normally were included in the study. ⋯ It may suggest that efficacy occurs by reduction in the intradiscal production of irritative products and by an effect upon discal and annular neoneuralization. The sustained nature of the benefit after long-term preoperative symptoms (mean, 4.7 years) rules out any placebo effect. Selection should be restricted to patients without significant lateral recess stenosis, retrolisthesis or olisthesis of > or =3 mm, significant dorsal or foraminal osteophytosis, extrusion, or sequestration.
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J Clin Laser Med Surg · Apr 2001
Randomized Controlled Trial Clinical TrialEndoscopic foraminoplasty: a prospective study on 250 consecutive patients with independent evaluation.
This study focused on the efficacy of endoscopic decompression of the foramen guided by endoscopic aware-state pain source definition. ⋯ Endoscopic laser foraminoplasty provides a minimalist means of exploring the extraforaminal zone, the foramen, the disc, and the epidural space and performing discectomy, lateral recess decompression, osteophytectomy, and neural mobilization. Performed in the aware state, it serves to identify and localize precisely the causal source of pain in multilevel disc disease, in revision surgery, and in the infirm and elderly without open fusion or decompression.
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J Clin Laser Med Surg · Feb 1999
Case ReportsEarly relief of erectile dysfunction after laser decompression of herniated lumbar disc.
The use of percutaneous laser disc decompression (PLDD) for the treatment of erectile dysfunction caused by herniated disc disease is described. ⋯ The literature now includes 23 cases well-documented cases of erectile dysfunction caused by spinal cord disc herniation. PLDD is a minimally invasive procedure that that can be used to treat herniation of intervertebral discs, which has been found to cause erectile dysfunction.
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J Clin Laser Med Surg · Dec 1998
Comparative Study Clinical TrialPercutaneous laser disc decompression (PLDD): twelve years' experience with 752 procedures in 518 patients.
Percutaneous laser disc decompression (PLDD) is a procedure in which herniated intervertebral discs are treated by reduction of intradiscal pressure through laser energy. This is introduced by a needle inserted into the nucleus pulposus under local anesthesia and fluoroscopic monitoring. The small volume of nucleus vaporized results in a sharp fall of intradiscal pressure, with consequent migration of the herniation away from the nerve root. First proposed by the author in 1984, this concept was validated by 2 years of in vitro experiments. Our aim was to apply this concept to a large series of patients with herniated disc disease. ⋯ PLDD has proven to be safe and effective. It is minimally invasive, is performed in an outpatient setting, requires no general anesthesia, results in no scarring or spinal instability, reduces rehabilitation time, is repeatable, and does not preclude open surgery should that become necessary.
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J Clin Laser Med Surg · Jun 1998
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialTreatment of medial and lateral epicondylitis--tennis and golfer's elbow--with low level laser therapy: a multicenter double blind, placebo-controlled clinical study on 324 patients.
Among the other treatment modalities of medial and lateral epicondylitis, low level laser therapy (LLLT) has been promoted as a highly successful method. The aim of this clinical study was to assess the efficacy of LLLT using trigger points (TPs) and scanner application techniques under placebo-controlled conditions. ⋯ This clinical study has demonstrated that the best results are obtained using combination treatment (i.e., TPs and scanner technique). Good results are obtained from adequate treatment technique correctly applied, individual energy doses, adequate medical education, clinical experience, and correct approach of laser therapists. We observed that under- and overirradiation dosage can result in the absence of positive therapy effects or even opposite, negative (e.g., inhibitory) effects. The current clinical study provides further evidence of the efficacy of LLLT in the management of lateral and medial epicondylitis.