Percutaneous Laser Disc Decompression (PLDD): Experience and Results From Multiple Centers and 19,880 Procedures

In mid‐February 1986, Peter Ascher and Daniel Choy performed the first Percutaneous Laser Disc Decompression (PLDD) at the Neurosurgical Department, University of Graz, Graz, Austria. It was planned to deliver 1000 joules with a Nd:YAG laser to a herniated L4‐5 disc causing sciatica. At 600 joules the procedure was terminated because the pain was gone.Since then, PLDD has spread all over the world, with procedures being performed in the entire spine except for T1‐T4 because these discs do not permit percutaneous access with a needle. The success rate has ranged from 70 to 89%, and the complication rate, chiefly discitis, from 0.3 to 1.0%. When successful, return to normal work averages one week. Long term follow‐up to 23 years yields a recurrence rate of 4–5%.