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The current evolution of the treatment of spine and whole body disorders in general moves towards the development of less invasive surgical techniques, called in the international medical language "minimally invasive surgery";
Laser Percutaneous Discectomy is at the forefront of minimally invasive surgeries for intervertebral disc disease, which allows to reduce aggression to the human body, decrease the periods of hospitalization and recovery, as well as reduce treatment costs in general.
Percutaneous discectomy or nucleotomy is a new method used to eliminate herniated discs from the spine at both the lumbar and cervical levels, without the need to surgically intervene by opening multiple planes of the human body until reaching the spine as it was done. formerly. This surgical intervention is performed with the awake patient who suffers no pain thanks to the local anesthesia with sedation that will be administered, and basically the method consists in performing a lateral opening of the intervertebral disc to extract the hernia, through instruments special, which guarantee the least possible damage to the human body with greater precision, effectiveness and fewer post-operative complications.
Classically to correct the herniated disc an open surgery was carried out, known as laminectomy. Then the open disc surgery with microscope appeared, equal to the laminectomy but with a smaller operative wound extension, with less adverse effects , but could produce the same as classical laminectomy EPIDURAL FIBROSIS, is still practiced, but less frequently.
The discectomy arises in the absence of a good result in 100% of cases when practicing classical surgery for herniated disc (laminectomy), in which 40% of patients have some type of postoperative problem and of those 40 % A not insignificant percentage performs a POSTOPERATORY FIBROSIS (defective postoperative internal scar that compresses even more than before the nerves that were compressed by the herniated disc) whose consequence is quite unfortunate on the functional plan.
At present, the treatment of herniated discs has been resorted to using the Holmium-Yag Laser or "contact laser" (The ablation capacity of Holmium-Yag laser in lumbar interverbral discs-Leu et coll-Zurich- Suisse), a technique that can be summarized as follows: A cannula is inserted percutaneously, of less thickness than that of a plastic spare part of a ballpoint pen, which includes: a laser fiber that is like a micro-television camera , irrigation and aspiration hoses, a mechanism that allows mobilizing the tip of the laser fiber according to the surgeon's requirements, allowing it to have a very precise control over the instrument.
Once the cannula is inserted, the surgeon will explore inside the affected disc, through the video system, which will give a clear vision of exactly what the patient's condition is. Applying the laser, the specialist will be able to disintegrate the damaged parts of the affected intervertebral disc, reducing the disc and nerve root pressure that the hernia can cause, providing immediate relief to the patient.
We can mention that this "contact laser" can coagulate in liquid medium without producing nerve stimulation. In addition, the thermal elevation at the level of the intervertebral discs is: 10 degrees centigrade in the nucleus, 1 degree centigrade in the posterior common vertebral ligament and 4 degrees centigrade in the vertebral plates. (Ablation rates and temperatures profile of Holmium-Yag laser ablation of intervertebral discs-Kutschers, Nneuchatel-Suisse), temperatures that guarantee a range of patient safety, never before achieved by any other type of device used for the treatment of interdiscal hernias. the spine.
One example known for years for the general population would be the development of laparoscopy practiced by almost all the general surgeons, this technique that may resolve abdominal diseases "without opening the abdomen," as was done classically through small holes made in the skin of the abdomen to the introduction of instruments and appliances that let you watch a television camera particularly suited for these operations.
In the specific case of the spine and taking as example the most common condition in it as serious disc herniation, lumbar either (on the lower back) or cervical (neck), progress in recent years have been very important through the application of bio-medical engineering and the development of sophisticated machines and equipment they have with the ultimate goal of treatment of this disabling disease of the spine that causes so much trouble for the normal development of the normal activity of daily life with a diminishing aggression to operate the patient.
