Percutaneous laser disc decompression (PLDD) is an entirely new approach to the treatment of herniated intervertebral disc d- ease. The traditional laminectomy and discectomy procedure was first performed at the Massachusetts General Hospital in 1934. In the intervening 69 years, science has moved forward with m- netic resonance imaging, sequencing of the human genome, ion propulsion, landing men on the moon and robots on Mars, the laptop computer, global positioning system navigation, black hole theory, string theory, and the successful cloning of animals. And yet, the same soft tissue-destroying, scar-inducing, pos- rior wall-weakening, and spinal instability-inducing cutting - eration is still being taught and performed. Advances in ort- pedics and neurosurgery occur slowly. Percutaneous laser disc decompression is minimally invasive; it can be performed as an outpatient procedure, requires no g- eral anesthesia, and has a high success rate, a low recurrence rate, and a low complication rate. By the middle of 2002, some 35,000 PLDD procedures had been performed worldwide. This book covers the history of the development of PLDD, laser physics, anatomy and pathophysiology of the herniated disc, the physics and mechanical principles that form the basis of PLDD, patient selection, radiographic considerations, the neurologic - amination, a step-by-step description of the PLDD procedure, the complications of PLDD and their treatments, special cases amenable to PLDD, postoperative care, and rehabilitation pro- dures. In short, this is a compendium of PLDD from A to Z.
