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PLDD - Percutaneous Laser Disc Decompression

AnonymousUserAAnonymousUser Posts: 49,002
edited 06/11/2012 - 8:39 AM in Back Surgery and Neck Surgery
Have had sciatica for about 4 mos now. I met with a surgeon for a microdiscectomy a couple of times and yesterday I called his secretary and booked a surgery date.

However, the other day I was researching alternative treatments and came upon this procedure done by a doctor in New York City who also seems to have invented it.

Unlike PLDD microdiscectomies, this treatment uses a needle inserted with the help of flouroscopy into the disk. A thin fiber optic laser (i believe) is then inserted into the needle to heat the nucleus of the disk. The disk evaporates causing a pressure gradient pulling the herniation back towards the disk. There is no incision and is therefore much less invasive.

The doc claims to have a success rate of 80%.

Anybody familiary with this?
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1

Comments

  • good article...

    I dont know however, why authors end it on a down note...
    the success rates in the larger studies are greater than 75%.

    Thats not bad considering how less invasive it is than microdisectomy.
  • My doc was the 7th in this country to perform this surgery. I don't think that the doc in NY invented it. My doc was trained by a doc in another country I think.

    Anyway. It is absolutely worth trying before doing anything more invasive. The worst that could happen is that it does not work and you have to go for the more major surgery.

    The PLDD will actually tighten up the disc and make it much less likely that the disc will reherniate unlike other surgerys that carry a high risk of reherniation.

    I no longer have nerve pain running down my leg but I do have back pain. I also have other issues in my spine that are causing my back pain.

    My opinion is that you have nothing to lose by trying this first. I have been seeing my doc for 4 years and have seen many folks that have not been able to find help anywhere else after searching for years. This procedure did help them.

    Good luck and keep us posted.

    I had this done 2 years ago
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  • I knew that you were misinformed but I wanted to make sure. PLDD has only been available in the US since 1991. Dr Choy is the doc that invented it and he is the one that trained my doc. Here is the information that I looked up

    The first clinical percutaneous laser disc decompression was performed in Europe by Choy and Ascher in 1986 [5]. The U.S. Food and Drug Administration approved PLDD for use in the USA in 1991.

    Hope it helped.
  • IDET?

    I guess the difference is the use of a laser instead of a thermal coil,...hmmmm.

    Looks like a good minimally invasive option to try before surgery.

    GL
  • I know its a sin, understandably, on this forum to mention drs by name, i believe its necessary here since there are so few in the field doing this procedure.

    I am seeing dr. choy tomorrow. I cant find any one on the internet who does the procedure the same way. In fact, from what i have read, the guy literally wrote the text book on the procedure and invented the instruments involved.

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  • Dr. Choy absolutely invented this procedure. My doc does it exactly the same way that Choy does. I think that he will be an excellent choice. Good luck and let me know how you make out.
  • After the consulation ($400), I decided not to do this.
    Several reasons...
    1) the office, despite being in a posh area of manhattan is dreary looking and poorly lit. I was one of only two patients there.
    2)The doc tries to sell you more on his inventions and accomplishments than on the procedure, although he does give you the percentages of sucess and failure, why, and what happens if there are complications (only 10 in 7000 due to infections which were later treated and cured).
    Success for me based on my age,etc was determined to be 89%.
    Failure would be due to detached particles of disc not visible in the MRI.
    3)He goes over your MRI but proceeds to diagnose you by your flexibilty and strength in your legs and feet.
    I went to him for 1 disc... he concluded based on these rather quick and simple tests that i have 3 disks that need treatment!!!!

    It sounded to me like that was an upsell and you dont really want to be upsold on something this serious if you don't need it, even forgetting about the additional cost per disc.

    Finally, most of the literature I saw on this procedure seems to be written by him!!!

    I am scheduled for surgery in 2 wks but i am calling that off too. Both the surgeon and the PLDD doc said I would have to give up the gym, weights, running, skiing, jumping, picking up my toddler daughter, you name it. I've had this bad disc for 10 yrs while doing all this (okay maybe heavy squating years ago wasnt the best, nor recent running). But I'm not going to let this change my life.

    On the recommendation of a chiro friend, im seeing a chiro w/ a drx9000 machine. This guy had a much more positive attitude. Along w/ the machine, he does some table work to relieve the disk and tens to relax the muscles after they have been stretched on the drx. 3 x a week for 8 wks @3200. He says I should feel improvements in ~12 treatments.

    As far as the PLDD treatment, I still can't say whether it would work or not. Unfortunately, I don't know. If he said I only had to do 1 disc, I might have done it.
  • about the DRX machine and outcomes? I could be incorrect, but it seems many of the folks here who tried it didn't find it very helpful. I hope, at that cost, it is helpful for you.

    Linda

    3 level spinal fusion, L3/4, L4/5, L5/S1, November 2008. Stiff, but I can walk.
  • All the DRX gave me was a very sore back and finacial heartache (not covered by eaither of my insurance companies unless done at PT) I had to pay out of pocket for 18 treatments. I kept asking if the billing department had asked my insurance and kept getting the "we are working on it" then I was presented with a bill for $2500. I am not kidding.

    Honestly my understanding is the DRX is great for new injury not old injury and not to be done on people with instability issues.

    Good luck,

    Julie
  • I had nucleoplasty done on C4/C5, C5/C6 and even though my symptoms are the same C4/C5 went away on the post procedure MRI. I'm wondering if the nucleoplasty didn't work for C5/C6 do you think PLDD will work on that level?

    Nucleoplasty is similar to PLDD in the sense that a needle is inserted into the disc and then radiowaves are sent into the disc to shrink the disc, the recovery period was about the same.

    I only ask because the docs seem to think C5/C6 is my problem area. Its a midline mild & contained disc protrusion no narrowing of foraminal but causing mild spinal stenosis.

    I have no noticeable arm or hand pain/tingling/burning but my neck is always nagging and my upper back is constantly sore. I'm not necessarily a patient for ACDF yet, nor do I want to take that leap.

    Thought anyone?
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