This surgical technique consists of a percutaneous approach for the treatment of small to medium size hernias of the intervertebral disc by laser energy. The main objective is to reduce the intradiscal pressure in the nucleus pulposus (the inner core of the vertebral disc) in such a way that the herniated fragment can be redirected to the interior of the disc, thus reducing the compression of the nerve root, which decreases pain, and therefore improves the morbidity and quality of life of the patient. Therefore, this approach consists in the "elimination" of part of the nucleus pulposus by the application of laser energy in the center of the intervertebral disc that produces a vaporization of its aqueous content. Being a minimally invasive technique, it is expected that the damage to the tissues (muscles, bones, ligaments and nerves) is the least possible. In addition, patients are expected to have less pain, a shorter hospital stay, with a quick recovery compared with the conventional surgical intervention. It is a procedure that can be an option for different states of disc degeneration and although it can be applied to all regions of the spine, it is used with greater frequency in lumbar disc hernias. Currently, modifications of this technique have been developed that consist of directing the needle closest to the herniated area of ​​the disc and evaporating specifically this region only or focusing on  the extruded part of the hernia. In the first case, it divides the disk into four quadrants and vaporization is done in the center of the quadrant closest to the hernia, instead of in the part of the disc as in conventional percutaneous laser treatment. According to these studies, better clinical results are observed than with the central vaporization of the disk. At The London Spine unit at Harley Street Hospital we specialise in laser disc surgery and achieve very successful outcomes due to the precision of our surgeries.

Essentially Medical Mr Mo Akmal  researchgate  bbc2

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