Comparison of results of 500 microdiscectomies and 500 percutaneous laser disc decompression procedures for lumbar disc herniation.

OBJECTIVE: This article aimed to analyze the neurosurgical results of 500 patients treated with microdiscectomies and 500 patients treated with percutaneous laser disc decompression. BACKGROUND DATA: It has been suggested in the literature that percutaneous laser disc decompression might be considered a serious and valid alternative to microdiscectomy in the treatment of patients with discogenic pain caused by herniated lumbar disc. METHODS: Patients with herniated discs were treated by microdiscectomy (n = 500) according to the Caspar technique, and patients with discogenic pain were treated with percutaneous laser disc decompression (n = 500) according to the Choy technique. The inclusion and exclusion criteria were the same for both groups of patients. Age, gender distribution, multiple levels involved, and associated pathologies were not statistically different. The results were evaluated for both groups with the MacNab criteria. The follow-up period was 2 years (+/-1 year). RESULTS: In the microdiscectomy group, 85.6% of patients (n = 428) had a good or excellent outcome; in the percutaneous laser disc decompression group, 83.8% of patients (n = 419) had a good or excellent outcome. Complications occurred in 2.2% (n = 11) in the microdiscectomy group and in 0% in the percutaneous laser disc decompression group. CONCLUSION: The analysis of results for the two groups supports the conclusion that percutaneous laser disc decompression is a safe, minimally invasive, and strong alternative treatment to microdiscectomy in patients affected by herniated discs.