Column What is PLDD? What kind of patient is it indicated for? What does it involve? We answer all your questions! (article supervised by a practicing surgeon)
June 28, 2024
Various treatments exist for disc herniation.
There are conservative treatments, surgical procedures to remove the herniated disc, and, in recent years, intervertebral disc treatments that target the herniated disc.
In this article, we will specifically discuss PLDD (laser therapy), one of the intervertebral disc therapies.
What is PLDD?
PLDD stands for Percutaneous Laser Disc Decompression.
This treatment has been performed since the 1980s and has a long history here. Many patients in Japan have received this treatment in the past.
PLDD is reserved for disc herniation and is not applicable to cases where the disc is collapsed or has been worn down.
The PLDD Technique
PLDD is performed under local anesthesia and a 1 mm needle is placed into the disc from the back with the use of fluoroscopy. A laser fiber is then passed through the needle, and the laser cauterizes a portion of the nucleus pulposus within the disc. This creates a cavity in the nucleus pulposus and causes the disc to shrink. The effect is to reduce nerve compression and improve pain and numbness.
Advantages and Disadvantages of PLDD
Advantages of PLDD
・PLDD is effective not only for herniated discs but also for non-specific low back pain.
・It involves less physical strain on the patient’s body than the MED or LOVE methods.
・The procedure takes only 15 minutes and can be performed as a one-day treatment.
Disadvantages of PLDD
・It is not effective on all hernias.
・It is not covered by health insurance.
・The recurrence rate is 5%, which is relatively high *1
＊1: Daniel S.J. Choy, et al. Twenty-three years of percutaneous laser disc decompression (PLDD) – State of the art and future prospects. Medical Laser Application. Volume 24, Issue 3, 2009.
For patients who aim at reducing the recurrence rate
As mentioned above, laser therapy has a high recurrence rate. Studies have shown that 12.5% of patients underwent surgery after PLDD treatment. *2
The reason for this is that although it suppresses symptoms caused by herniated discs, it does not repair the discs themselves.
＊2: Masoud Hashemi, et al. The Long-term Effects of Percutaneous Laser Disc Decompression (PLDD) Treatment on Lumbar Disc Protrusion: A 2-Year Follow-up. Journal Of Lasers in Medical Sciences. 11(4), 2020.
To reduce the recurrence rate, the damaged disc must first be repaired. This can be achieved with the Cellgel method.
The Cellgel method
The Cellgel method is a treatment to repair a damaged disc.
A drug is injected that fills in the cracks in the disc, which then forms a gel that replaces the cracks, preventing further disc degeneration and thus providing a fundamental treatment.
It is characterized by the fact that the volume of the disc is not reduced, and the drug remains in the disc as a gel-like implant after treatment, thus preserving the disc.
The Cellgel method is indicated for both lumbar and cervical disc degeneration.
If you are suffering from back pain, please consider having a consultation at our clinic.
About the author of this article
Tadaaki Minowa, Orthopedic Surgeon
Academic Affiliations and Qualifications
The Japan Society of Low Back Pain
Japanese Society of Endoscopic Surgery
Japan Medical Association: Certified Industrial Physician
Japanese Organization of Medical Examiners for Cancer Therapy, Board Certified in Cancer Therapy
Certified physician of the Cellgel method
Certified physician of ozone therapy
Certified physician of the Florence method
