Lumbar Hernia Laser Treatment
Nucleoplasty
It can be applied to patients with herniated disc with mild nerve compression. It is a procedure performed in the operating room with a C-arm fluoroscopy X-ray device. With the help of local anesthesia, with the help of a needle, the intervertebral disc is entered through the hole called foramen, where the nerve exits the spine between both vertebrae. Fiber optic cable that provides laser transmission is passed through the needle. In the intervertebral disc, the laser, which creates a certain energy, burns the tissues in the disc and shrinks the herniated disc. This reduces the pressure on the nerve and relieves the patient's complaints. Nucleoplasty is a short procedure lasting 30-45 minutes that can be used in the treatment of lumbar hernia. The patient is discharged after a 2-4 hour rest.
Transsacral Epiduroscopic Laser Discectomy
In 10% of patients suffering from low back pain, no improvement is noted despite conservative treatment. Epiduroscopic laser discectomy method has become one of the minimally invasive surgical methods in the treatment of herniated disc. It was started to be used for diagnosis and treatment in 1966. It is possible to reach and treat the region of herniated disc by making a very small incision. This method can be easily applied to patients who have had herniated disc surgery or who have had a herniated disc surgery and who develop scar tissue around the nerve.
Application in Epiduroscopic Laser:
It is extremely simple. The patient is placed face down. In sterile conditions, imaging of the spine is performed using a C-arm x-ray machine. After local anesthesia applied to the coccyx area with a needle, 18 G, 90 mm from the sacral hiatus. length is entered with a needle. A guide wire is passed through it. The guide wire is sent by controlling the anatomic disc distance to be studied with fluoroscopy. A 3 mm skin incision is made. Through the wire, 3.8 mm. A dilator of +17.8 cm is sent. The dilator is removed and a flexible catheter is sent. A fiber optic camera and laser are passed through it. Serum saline is injected into the epidural space. By verifying the distance, the protruded disc (herniated disc) and adhesions are burned by the heat effect of the laser through an optical camera. After sufficient nerve root relaxation, depot steroid is injected and the catheter is withdrawn. A single suture is sufficient to replace the wound. It is a comfortable method in the treatment of lumbar hernia. The patient is discharged home after a 4-hour follow-up.
Dr. Tamer Tekin