Percutaneous endoscopic manual and laser discectomy for herniated lumbar discs

The flexible Ho:YAG laser could reach the posteriorly herniated portion of a lumbar disc, so that the laser ablated directly the base of the hernia mass and the surrounding annulus. Since the laser splits the adhesion of the bulged annulus to free the hernia mass, it could be easier to extract the hernia mass with pituitary forceps. Therefore after direct adheseolysis, shrinkage and ablation of the hernia mass by the laser, it becomes easier to extract the collagenous hernia mass with forceps (synergistic effect). 757 patients with herniated lumbar discs contained by the posterior longitudinal ligament were treated with the percutaneous endoscopic Ho:YAG laser discectomy following manual removal of the posterior and central nucleus.