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ADVANTAGES
• OPD Procedure
• Doesn’t preclude alternative surgical
options / procedures
• Reduce risk of complication
• Minimum soft tissue injury
• Immediate relief of pain
• No epidural fibrosis
PLDD
RADIOLOGICAL INVESTIGATIONS
• Plain X-rays under weight bearing condition
and in flexion & extension
• MRI Spine – Degree of disc protusion
– Position & Shape of
disc
• EMG :When signs of compression are
confusing or when assessment of likely
recovery of function is required
PLDD
PROCEDURE
● Cannula in disc space under C – Arm
● Discography - to Confirm
- to elicit memory pain
● laser fiber discectomy
PLDD
OUR EXPERIENCE
PLDD
Since Dec.2000, 100 consecutive spinal discs in
90 patients were treated using PLDD method
Patient Selection Rate - 20 %
Average Age - 42 Years
Male : Female - 65 : 25
Duration of Symptoms - 18 Months
Mean Follow Up - 12 Months
Success Rate - 84.9 %
NUMBER OF PATIENTS
> 65 05 02 07
TOTAL 65 25 90
PLDD
INVOLVED DISC LEVELS
LEVEL MALE FEMALE TOTAL
L1-2 01 02 03
L2-3 04 01 05
L3-4 07 01 08
L4-5 48 17 65
L 5 - S1 14 05 19
TOTAL 74 26 100
PLDD
INVOLVED DISC LEVELS
8 (L3-4)
65 (L4-5)
84
5 (L2-3)
3 (L1-2)
19 (L5-S1)
PLDD
Observations
Required Analgesics 50 10 02 -
Muscle Weakness 08 02 01 -
Persistent Numbness 50 05 03 01
PLDD
COMPLICATIONS SEEN :
No. Of Patients
●
Aseptic Discitis - 5 (Post Operative)
●
Psoas Hematoma - 1 (Post Operative)
●
Vasovagal reaction - 1 (Intra Operative)
●
Residual Radicular Pain - 6 (Post Operative)
●
Cauda equina - 1 (Post Operative)
Syndrome
PLDD
CONCLUSION
Post Operative
PLDD
Post Operative
PLDD