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The following article appeared in an advertorial in The New York Times on Sunday, April 29, 2007 and was written by Sharon Johnson.


If you have ever said, “Oh my aching back,” you have plenty of company. Eight out of 10 Americans will suffer back pain at some point in life, according to the National Institutes of Health (NIH).

One frequent cause of debilitating back pain is a herniated disk, the soft rubbery pad found between each of the vertebra that allows flexing or bending. A ruptured disc occurs when part of the center nucleus pushes the edge of the disc into the spinal canal, putting pressure on the nerves and causing pain in both the back and legs.

In the past, many people who weren’t helped by conservative treatments like medications and exercise had laminectomy surgery, which involved removing a portion of the vertebral bone. Performed under general anesthesia with a long hospital stay, the procedure made recovery difficult. Worst of all, many people developed “failed back syndrome,” because their pain continued despite the surgery.

Fortunately, today there is another option: PLDD (percutaneous laser disc decompression), a minimally invasive technique pioneered by Dr. Daniel S.J. Choy, founder of the Laser Spine Center in Manhattan. Approved by the FDA, the procedure is performed on an outpatient basis using only local anesthesia.

“During the procedure, a thin needle is inserted into the herniated disc under x-ray guidance,” says Dr. Choy who has performed more than 4,200 PLDD procedures since 1986. “An optical fiber is inserted through the needle and laser energy is sent through the fiber, vaporizing a tiny portion of the disc nucleus. This creates a partial vacuum, which draws the herniation away from the nerve root, thereby relieving the pain. The effect usually is immediate.”

Patients receive a small adhesive bandage and return home for 24 hours of bed rest. Then they begin progressive ambulation, walking up to a mile. Most white-collar workers return to work in five days; manual laborers require several additional days of recuperation.

“PLDD offers many advantages,” says Dr. Choy. “Because only a thin needle is used, there is no cutting and no scarring. Since only a tiny amount of disc is vaporized, there is no subsequent spinal instability. PLDD is different from open lumbar disc surgery because there is no damage to the back muscle, no bone removal or large skin incision. Most of the complications that may occur with open surgery are eliminated with the PLDD procedure.”

Dr. Choy has performed PLDD on patients ranging in age from 16 to 92. Many of them suffered from sciatica, a sharp, often shooting pain that extends from the buttocks down the back of one leg. Other signs of a herniated disc may include a burning pain centered on the back, a tingling or numbness in one leg or a weakness in one leg.

“My success rate over the past 20 years has ranged from 80 to 89 percent,” says Dr. Choy.

The procedure is now used worldwide with more than 120,000 PLDD procedures being completed. Dr. Choy has trained over 300 neurosurgeons and orthopedic surgeons in the technique and presented papers and demonstrations at medical conferences around the world. He also wrote a textbook, “Percutaneous Laser Disc Decompression,” published by Springer-Verlag in 2003.

"After I had written my column about fibromyalgia, I received phone calls from readers telling me their pain and muscle spasms began with a herniated disc in their lower back or neck. That kind of thinking is not completely accurate. It should be broken down into two parts: understanding the nature of disc injuries and looking at what else is actually causing the pain." Read more.

—From "A New Approach for Eliminating Disc Pain" in The Sunday Star-Ledger

"The principle behind PLDD is that in a closed hydraulic space (such as an intervertebral disc), a small change in volume results in a large change in pressure. With the patient under local anesthesia, the physician inserts an optical fiber into the herniated disc via a discogram needle and vaporizes a small volume of the disc. The intradisc pressure falls, causing the herniated portion to retract away from the nerve root and toward the center of the disc." Read more.

—From "Laser decompression effective in select herniated disc cases" in Clinical Laser Monthly

"The technique works because ‘in an enclosed hydraulic space (like an intact vertebral disc), a minute change in volume is accompanied by a disproportionately large change in pressure,’ said Dr. Daniel Choy at the annual meeting of the Canadian Orthopaedics Association held here recently." Read more.

—From "Laser Shot Helps Relieve Pressure of Herniated Disc" in The Medical Post

"The severe back pain of a herniated disc is generally treated with bed rest, physical therapy, and drugs. When all this fails, some sufferers resort to major surgery. But a new form of laser surgery developed by Columbia faculty has helped 75 percent of the 121 patients." Read more.

—From "Zapping Back Pain" in The Magazine of Columbia University

"According to Dr. Choy, some patients treated with PLDD show marked improvement immediately after the procedure; a return of an absent ankle reflex or more flexibility on a straight-leg raising test is often observed, he said. All patients are able to walk out of the hospital right away, and may return to work in three days or less, he added." Read more.

—From "Disc treated with laser" in the Medical Tribune

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