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About PLDD Laser Surgery

Percutaneous Laser Disc Decompression

PLDD is a minimally invasive laser treatment performed using local anesthesia for disc hernia/protrusion in selected patients.

The following will introduce in detail

the progress of the surgery.

PLDD is an abbreviation of Percutaneous Laser Disc Decompression. Insert a thin needle to the intervertebral disc under the  X-ray guidance. Laser fiber is injected through the needle to burn the nucleus pulposus. Laser irradiation makes a heat denaturation and makes a cavity in intervertebral disc, and herniated disc retracts(decompress).

PLDD takes a only around 15 minutes. After surgery, patient needs a rest on the bed for 1 or 2 hours. After that, patient can go home the day of surgery.

In this surgery, no need to use general anesthesia, only using local anesthesia. In addition, patient no need to be hospitalized.


The following animation video is  introducing about PLDD laser surgery in detail, and easy to understand.

You can check the progress of the surgery.

Theory of PLDD

(Percutaneous Laser Disc Decompression)

At the PLDD, send a laser energy to the nucleus pulposus (the core of intervertebral disc), the heat of laser vaporizes and burns the soft tissue.
It makes a cavity inside of the disc and makes a heat denaturation (thermal denaturation) on the protein tissue. This heat denaturation is a power of shrinking inward. Thereby the internal pressure is decreased.
Because of these reactions and processes, the nerve root reliefs from the pressure and the symptoms due to disc
herniation be improved.

What is a “heat denaturation”?

If add a heat energy to protein materials, a protein reacts to this heat and changes the properties.
When we cook a baked chicken, this chicken becomes smaller than before cooking, but the total volume of chicken does not change. Only an amount of moisture is decreased by the heat energy, and chicken becomes tighten up and shrinks.
A same reaction happens to the herniated disc at the PLDD. By the heat of laser energy, this heat denaturation happens and herniated disc becomes tighten up and shrinks.

After the herniated disc becomes tighten up and shrinks by PLDD,the intervertebral space becomes thinner?
If patient undergoes Discectomy surgery, the intervertebral disc is completely extracted.

It means that after Discectomy surgery, the intervertebral space is easy to be narrow. Also if put some metallic medical device into the space, there is a possibility that the spine movement gets harden.
However, at this PLDD, there is a possibility that the intervertebral space to be narrow a little bit, but the total volume of disc is not changed. It means that PLDD does not makes the intervertebral space thinner like a Discectomy surgery.

Are there any possibility that the disc herniation relapse after PLDD?
After PLDD, the intervertebral disc becomes stronger than before with reaction of heat denaturation (tighten up and shrinks). Therefore, basically it never relapse.

How long it takes a time to recovery the symptoms?
After the internal pressure of herniated disc has decreased, the disc herniation is getting smaller gradually. But there is an individual differences between each patient in the term of recovery and result.
If the disc herniation happened a long time ago, this herniated disc has been harden. In that case, it takes a time or hard to be tighten up or shrinks. But the effect of PLDD occurs steadily, also the disc keeps shrinking for around 6 months after the procedure. Therefore, the postoperative patient needs to be observed for 6 months.


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