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What is percutaneous laser disc decompression?

Mr Malik is one of the UK’s leading minimally invasive spinal surgeons. He will be discussing what this exciting new procedure is, how it works and conditions that it can be used treat.

Mr Malik is one of the first surgeons to adopt this new percutaneous technique, he also introduced endoscopic spine surgery to the UK.



Worldwide, back pain is one of the leading causes for disability. A herniated disc is one of the major causes for chronic lower back pain and sciatica. This is where the spinal discs put pressure on to the nerves, resulting in pain in the back and down the patient’s leg.


Percutaneous Laser Disc decompression (PLDD) is a relativity new treatment, which is one of a kind, due to how minimally invasive it is. During the procedure a micro-needle is inserted in the centre (nucleus) of the spinal disc, via the foramina. To ensure that the insertion is in the correct local, the surgeon is guided using an X-ray. A thin fibre is then inserted into the disc, via the needle; it is this fibre that delivers the laser energy to the disc nucleus. Thermal energy that comes from the laser heats up excess fluid in the disc, which is then evaporate.


This process shrinks the disc and releases pressure on the nerves to relieve the pain.

One of the main benefits that is associated with PLDD, is that patient can be treated as outpatients, meaning that in most cases the patients will be able to return home the same as the procedure.


As the procedure is minimally invasive and does not involve a large incision or muscle disruption (for example open spine surgery), it can be done under a local anaesthetic. The benefit to having a local anaesthetic over a general anaesthetic is that the rehabilitation period is a lot shorter, which is the main reason as to why patients are discharged within 24 hours.


The main indications for this procedure are:

  • Refractory back pain

  • Contained disc which is causing compression (pressure) on nerve root

  • Conservative treatment unsuccessful, including physio and pain management

  • Annular tear

  • Sciatica


The benefits of PLDD include:

  • No soft tissue injury

  • No epidural scarring

  • No excessive hospital stays (mostly just outpatients)

  • No general anaesthesia

  • Minimal recovery time


This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.

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