PLDD treatment for anular tears, rim lesions or disc ruptures.
 

Regards,

this is very direct and specific question, not for patients with "normal" back pain or disc hernination.

Its directed to people with either:
1. Anular tears
2. Rim lesions
3. Disc ruptures
4. similar types of IDD (internal disc disruption)

What type of treatment did you had?

Did anyone had treatment by Daniel Choy's method called PLDD (Laser).

Thanks.

Keano,

I had a disc rupture back in 1994 and had an emergency discectomy/laminectomy. I believe the treatment was appropriate at the time. However, I do wish that I had been told the liklihood of further degeneration.

Yes, but I suppose that your disc was preassuring nerve root?

With IDD, internal disc nerve (probably sinuvertebral nerve) is irritated.
Discectomy/Laminectomy, as far as I know, is not appropriate for this types of conditions I mentioned.

All best.

I have one client w/3-level PLLD w/Choy in 2006. He is one of the very unlucky few who contracted discitis from what should be a very minimally invasive and low risk procedure. (I still believe the risk of discitis is VERY low and don't know what to think of this... however, I don't think ill of Dr. Choy because I don't know enough about the situation.

IMHO, plld is for people who are not that far down the degenerative cascade. If the degeneration is advanced (as it is in most of the people I run into), I think PLLD is too little too late. For those who are good candidates, it seems like one of the good MISS's available.

Mark

Yes, it can occur, but not so often.

Yes, that is why I opened this thread. Because there are some indications that PLDD can help people with anular tears (which is advanced degeneration), and I've heard of some cases (Dr. Choy also mentioned something about that) where PLDD is used for treatment of anular tears, rhizotomy, etc.

So I am seeking for experiences.

Here is a proof that PLDD can help if you have annular tear or IDD causing pains by sinu-vertebral nerve irritation:

Percutaneous laser disc decompression in the treat...[Photomed Laser Surg. 2004] - PubMed Result

L3, L4 and L5S1 tx
 

L3 has an annular tear x 20 years. Done nothing for it. Has been problematic in past but not in last 10 years.

L4- percutaneous discectomy in '92/failed. Worse. Rebulged. Get lumbar ESIs transforaminally for relief plus pain meds and Gabapentin for neuropathies.

L5S1- open discectomy and partial laminectomy in '89/better but rebulged and more problematic. Get lumbar ESIs transforaminally for relief plus pain meds and Gabapentin for neuorpathies.

My problems are very old (originating in 1982). Have been offered an array of surgeries from 3 level global fusion to 2 level ADR to ADR plus fusion. So far have decided to do nothing except continue conservative therapy as long as possible.

I imagine laser is for newer (more recent) bulges, tears and so forth.

I have recently seen annulus repair devices used. This will give us more options for minimally invasive procedures for people who have advanced further down the degenerative cascade, making us poorer candidates for the easier and less invasive options.

Mark

Please give more info ASAP.

Thanks.