PMID- 23615885
OWN - NLM
STAT- MEDLINE
DCOM- 20131108
LR  - 20220410
IS  - 2150-1149 (Electronic)
IS  - 1533-3159 (Linking)
VI  - 16
IP  - 2 Suppl
DP  - 2013 Apr
TI  - Percutaneous lumbar laser disc decompression: an update of current evidence.
PG  - SE229-60
AB  - BACKGROUND: 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. STUDY 
      DESIGN: A systematic review of the literature of percutaneous lumbar laser disc 
      decompression. OBJECTIVE: 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. METHODS: 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. OUTCOME MEASURES: 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. RESULTS: Based on USPSTF criteria, the indicated level 
      of evidence for percutaneous lumbar laser disc decompression is limited for 
      short- and long-term relief. LIMITATIONS: Although laser discectomy has been 
      utilized for many years, there is a paucity of randomized clinical trials. 
      CONCLUSION: This systematic review shows limited evidence for percutaneous lumbar 
      laser disc decompression.
FAU - Singh, Vijay
AU  - Singh V
AD  - Spine Pain Diagnostics Associates, Niagara, WI 54151, USA. vj@wmpnet.net
FAU - Manchikanti, Laxmaiah
AU  - Manchikanti L
FAU - Calodney, Aaron K
AU  - Calodney AK
FAU - Staats, Peter S
AU  - Staats PS
FAU - Falco, Frank J E
AU  - Falco FJ
FAU - Caraway, David L
AU  - Caraway DL
FAU - Hirsch, Joshua A
AU  - Hirsch JA
FAU - Cohen, Steven P
AU  - Cohen SP
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
PL  - United States
TA  - Pain Physician
JT  - Pain physician
JID - 100954394
SB  - IM
MH  - Diskectomy, Percutaneous/*methods
MH  - Humans
MH  - Intervertebral Disc Displacement/complications/surgery
MH  - Laser Therapy/*methods
MH  - Low Back Pain/etiology/*surgery
MH  - Lumbar Vertebrae/surgery
MH  - *Outcome Assessment, Health Care
MH  - Pain Management
EDAT- 2013/05/03 06:00
MHDA- 2013/11/10 06:00
CRDT- 2013/04/26 06:00
PHST- 2013/04/26 06:00 [entrez]
PHST- 2013/05/03 06:00 [pubmed]
PHST- 2013/11/10 06:00 [medline]
PST - ppublish
SO  - Pain Physician. 2013 Apr;16(2 Suppl):SE229-60.