Usefulness of carbon dioxide laser for recurrent lumbar disc herniation

Objective: During revision microdiscectomy for recurrent lumbar disc herniation (rLDH), The major concerns are approach-related complications, including dural tear and nerve root injury, because of adhesion scars and granulation tissue along The previous laminotomy site. In revision microdiscectomy of rLDH, carbon dioxide (CO ₂) laser can enable precise dissection and removal of adhesion scar. The purpose of this study was to evaluate The clinical usefulness of CO ₂ laser dissection in patients who had undergone revision microdisectomy of rLDH. Methods: Clinical and radiologic data were reviewed from 21 patients who underwent single lumbar level CO ₂ laser dissection followed by removal of rLDH between October 2006 and July 2010. They were followed up with plain radiographs, and their mean follow-up period was 30 months. Results: Patients' mean hospital stay after operation was 5.1 days. Pain scores on a visual analogue scale (VAS) for back and leg pain were improved from a preoperative mean of 4.7 and 7.6 to a postoperative mean of 3.5 and 3.0, respectively (p<0.001). Clinical outcomes based on The Oswestry Disability Index (ODI) were improved from a preoperative mean of 57.4-22.2% postoperatively (p<0.001). Conclusions: Our results demonstrate that CO ₂ laser could be a useful surgical tool during revision microdisectomy of rLDH.