MRI changes and clinical results of low-energy semiconductor percutaneous laser disc decompression（LS-PLDD） for lumbar disc herniation in adolescents

Abstract Purpose Low-energy semiconductor percutaneous laser disc decompression (LS-PLDD) is a minimally invasive surgical method that uses a laser to treat lumbar disc herniation. However, there is currently no clinical efficacy evaluation of this surgical method for treating lumbar disc herniation in adolescents. This study aimed to evaluate the safety and effectiveness of LS-PLDD compared with percutaneous endoscopic discectomy (PELD) in the treatment of adolescent LDH patients. Methods collected data on 30 adolescent LDH patients who received LS-PLDD in our center, 60 adolescent LDH patients who received PELD in our center were matched based on age and gender. The lumbar ODI and back pain VAS score before surgery and 1 week, 1 month, 3 months and 6 months after surgery were collected to evaluate the clinical outcome of two groups. And we also compared the lumbar MR imaging examinations before surgery and 3 months after surgery to observe the changes of MR of disc. Results The preoperative back VAS scores were (7.0 ± 0.91) and (7 ± 0.8) in the LS-PLDD group and PELD group respectively, with no significant statistical difference (P = 0.779). The VAS scores of both groups had improvement after surgery. At the last follow-up, the VAS scores of both groups were (2.0 ± 1.3) and (1.0 ± 0.8) respectively ( P < 0.01). The VAS scores of patients in PELD group improved most significantly in the first week after surgery and then gradually stabilized, while that in LS-PLDD group improved more gradually during 6 months after surgery. The preoperative ODI scores of the LS-PLDD group and PELD group were (71.1 ± 7.9)% and (68.0 ± 7.3)% (P = 0.061), at the last follow-up, the ODI scores were (28.0 ± 13.1)% and (19.0 ± 8.4)% (P < 0.01). The preoperative canal cross-sectional areas in the LS-PLDD group and PELD group were (1373.0 ± 376.6) and (1457 ± 415.9) respectively, with no significant difference between the two groups (P = 0.157), at the last follow-up, the canal cross-sectional area of the surgical segments were (1373 ± 476.6) and (1457 ± 579.1) (P = 0.227)respectively. Conclusions This study shows that low-energy semiconductor laser LS-PLDD is a safe and effective treatment method for adolescent LDH. It can achieve sustained retraction of the herniated disc and retain the intact structure of the disc.