What is a laser diskectomy?

A laser diskectomy surgically removes the bulged out part of an intervertebral disk.
A laser diskectomy surgically removes the bulged out part of an intervertebral disk.

A laser diskectomy (diskectomy or percutaneous laser diskectomy) is a surgical procedure in which the bulged out part of an intervertebral disk (herniated disk) in your spine is removed by evaporating it by using laser energy delivered through a small incision (minimally invasive surgery) made on the skin and soft tissues over the affected disk. A minimally invasive technique, a laser diskectomy causes less pain and has a fast recovery rate.

The spine or backbone is composed of a series of bones called the vertebrae. The chain of vertebrae forms a hollow column or path through which the spinal cord runs in a way that the vertebrae protect the cord from injury. 

The vertebrae rest on each other with disks (intervertebral disks) between each vertebra to provide cushioning and support. Many nerves from the spinal cord pass through small holes in the vertebrae called foramen.

In some conditions, such as aging, injury, or certain infections, the outer wall of one of these disks may dry out and weaken, and the soft, inner part of the disk bulges out. This condition is called a herniated or bulging disk. 

The bulging disk may press on the nerves and spinal cord to cause symptoms such as pain, weakness or tingling. In such cases, a laser diskectomy can remove the part of the disk compressing the nerves by burning it with a laser, providing relief.

What happens during a laser diskectomy?

  • A laser diskectomy is an outpatient procedure, which means you can go home the same day. You may, however, need someone to drive you back home.
  • The anesthetist administers local anesthesia with light sedation so that you do not feel any pain or discomfort during the procedure.
  • The surgeon monitors your vitals (such as blood pressure and heart rate) during the procedure.
  • The skin is cleaned with antiseptic, and drapes are applied.
  • The surgeon makes an incision (a small surgical cut) on your back at the level of the affected disk.
  • The surgeon uses fluoroscopy (an imaging technique) to find the correct location.
  • The surgeon advances a thin needle through your back under image guidance.
  • Once the needle reaches the desired location, laser energy is applied to vaporize the part of the disk that is causing the problem.
  • The needle is removed.
  • A small bandage is placed to close the wound.

Who would need a laser diskectomy?

A laser diskectomy may be indicated in people who have a herniated disk, along with associated symptoms, such as pain, burning sensation, tingling, or weakness in the area supplied by the compressed nerve/s. 

Not every person with a herniated disk requires a laser discectomy, and the doctor may recommend surgery if conservative therapy such as medications, rest, physical therapy, and weight management have failed. 

All cases of herniated disk, however, cannot be treated with a laser discectomy, and some may require open surgery.

What is the success rate of a diskectomy?

A diskectomy is an effective procedure providing relief to many patients with a herniated disk. The success rate depends on many factors such as

On average, the success rate is approximately 80% for diskectomy. Some risks associated with the procedure are:

  • Discitis (inflammation of the intervertebral disk)
  • Infection
  • Excess bleeding
  • Blood clots
  • Nerve injury

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Medically Reviewed on 7/21/2020
References
Medscape Medical Reference
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