PERCUTANEOUS LASER DISKECTOMY

APPROXIMATELY 200,000 PATIENTS PER YEAR IN THE UNITED STATESUNDERGO THE SURGICAL REMOVAL OF LUMBAR DISKS. CANDELA LASERCORPORATION PLANS TO DEVELOP A LASER-BASED METHOD FOR PERCUTANEOUS DECOMPRESSION OF HERNIATED LUMBAR DISKS. A PULSED HOLMIUM:YAG LASER WITH A FIBEROPTIC DELIVERY SYSTEM WILL BE USED TO ABLATE MATERIAL AND REDUCE THE VOLUME OF THENUCLEUS PULPOSUS, ACHIEVING A CLINICALLY IMPORTANT REDUCTIONIN INTRADISK PRESSURE. A NOVEL INTRADISK PRESSURE-VOLUME COMPLIANCE CURVE WILL BE GENERATED EXPERIMENTALLY TO ESTABLISH THE IDEAL LASER PARAMETERS THAT YIELD THE GREATEST INCREASE IN DISK COMPLIANCE. CONCOMITANT STUDIES OF THERMAL EFFECTS WILL BE CONDUCTED WITH AN INFRARED THERMAL CAMERA. IN VITRO STUDIES ON PORCINE AND HUMAN CADAVERIC LUMBAR SEGMENTS WILL DIRECTLY COMPARE THE LASER TECHNIQUE TO THE NUCLEOTOME INSTRUMENT, WHICH REPRESENTS THE CURRENTLY ACCEPTED BEST TECHNIQUE FOR REMOVAL BY THE PERCUTANEOUS ROUTE. IN VIVO STUDIES ON PIGS USING THE ESTABLISHED PARAMETERS WILL BE CONDUCTED TO DETERMINE ANY UNTOWARD EFFECTS. POTENTIAL ADVANTAGES OF THE LASER METHOD INCLUDE: A MINIMALLY INVASIVE TECHNIQUE, A PROCEDURE PERFORMED ON AN OUTPATIENT BASIS, GREATER PATIENT ACCEPTANCE, AND A HIGHER CLINICAL SUCCESS RATE.