Percutaneous lumbar laser disc decompression: an update of current evidence.

Vijay Singh, Laxmaiah Manchikanti, Aaron K. Calodney, Peter S. Staats, Frank J E Falco, David L. Caraway, Joshua A. Hirsch, Steven Cohen

Research output: Contribution to journalArticle

Abstract

Since the descriptions by Mixter and Barr of surgical treatment for rupture of the intervertebral disc in 1934, open surgical procedures have become a common practice. Disc herniations are often classified as being contained or non-contained. The results of open surgical discectomy for contained disc herniation have been poor. Consequently, several less invasive techniques have been developed including percutaneous lumbar laser disc decompression. A systematic review of the literature of percutaneous lumbar laser disc decompression. The objective of this systematic review is to evaluate and update the clinical effectiveness of percutaneous lumbar laser discectomy in managing radicular pain secondary to contained disc herniation. The available literature on lumbar laser disc decompression in managing chronic low back and lower extremity pain was reviewed. Quality assessment and clinical relevance of randomized trials were graded according to the Cochrane Musculoskeletal Review Group criteria for interventional techniques, and observational studies according to the Newcastle-Ottawa Scale criteria.The level of evidence was classified as good, fair, and limited or poor based on the quality of evidence developed by the U.S. Preventive Services Task Force (USPSTF). Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966 to September 2012, and manual searches of the bibliographies of known primary and review articles. Pain relief was the primary outcome measure. Other outcome measures were functional improvement, improvement of psychological status, opioid intake, and return-to-work. Short-term effectiveness was defined as effectiveness lasting one year or less, whereas, long-term effectiveness was defined as benefit persisting for greater than one year. Based on USPSTF criteria, the indicated level of evidence for percutaneous lumbar laser disc decompression is limited for short- and long-term relief. Although laser discectomy has been utilized for many years, there is a paucity of randomized clinical trials. This systematic review shows limited evidence for percutaneous lumbar laser disc decompression.

Original languageEnglish (US)
JournalPain Physician
Volume16
Issue number2 Suppl
StatePublished - Apr 2013
Externally publishedYes

Fingerprint

Decompression
Lasers
Diskectomy
Advisory Committees
Pain
Randomized Controlled Trials
Outcome Assessment (Health Care)
Return to Work
Intervertebral Disc
Information Storage and Retrieval
Bibliography
PubMed
Opioid Analgesics
Observational Studies
Rupture
Lower Extremity
Psychology

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Singh, V., Manchikanti, L., Calodney, A. K., Staats, P. S., Falco, F. J. E., Caraway, D. L., ... Cohen, S. (2013). Percutaneous lumbar laser disc decompression: an update of current evidence. Pain Physician, 16(2 Suppl).

Percutaneous lumbar laser disc decompression : an update of current evidence. / Singh, Vijay; Manchikanti, Laxmaiah; Calodney, Aaron K.; Staats, Peter S.; Falco, Frank J E; Caraway, David L.; Hirsch, Joshua A.; Cohen, Steven.

In: Pain Physician, Vol. 16, No. 2 Suppl, 04.2013.

Research output: Contribution to journalArticle

Singh, V, Manchikanti, L, Calodney, AK, Staats, PS, Falco, FJE, Caraway, DL, Hirsch, JA & Cohen, S 2013, 'Percutaneous lumbar laser disc decompression: an update of current evidence.', Pain Physician, vol. 16, no. 2 Suppl.
Singh V, Manchikanti L, Calodney AK, Staats PS, Falco FJE, Caraway DL et al. Percutaneous lumbar laser disc decompression: an update of current evidence. Pain Physician. 2013 Apr;16(2 Suppl).
Singh, Vijay ; Manchikanti, Laxmaiah ; Calodney, Aaron K. ; Staats, Peter S. ; Falco, Frank J E ; Caraway, David L. ; Hirsch, Joshua A. ; Cohen, Steven. / Percutaneous lumbar laser disc decompression : an update of current evidence. In: Pain Physician. 2013 ; Vol. 16, No. 2 Suppl.
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