Percuteneous Laser Disc Decompression alias PLDD is a medical procedure that uses laser beams to treat back and neck pain caused by  disc herniations. Over the past 70 years, the traditional laminectomy and discectomy procedures were performed. As technology improved, minimally invasive approaches evolved. The first of its kind, Percuteneous Laser Disc Decompression (PLDD) started in the early 80’s and over time was fine-tuned to be a very useful procedure. The Percutaneous Laser Decopression is done by introducing a fibre optic wire inserted in the disc under X-ray guidance. The laser reduces the small portion of the inside disc material called nucleus pulposes.  Thousands of PLDD procedures were done around the world with success.

PLDD procedure reduces the incidence of conventional back surgery (laminectomy). In suitably selected patients the procedure dramatically minimizes the incidence of scarring and other complications of laminectomy. It is established that  PLDD reduces the intradiscal pressure and  the discogenic pain and the nerve compression pain diminishes and largely disappears.

In 1984, Dr. Choi and co-workers introduced laser energy into herniated/protruded disc to vaporize a small volume of nucleus pulposis reducing the intradiscal pressure. Pressure reduction creates a pressure gradient leading to migration of the herniated portion away from the involved nerve root. This is based on a physical principal of Pascal Law. In an enclosed hydraulic space, small change in volume will result in a large change in pressure. This model was tested successfully in Columbia University, College of Physicians and Surgeons in New York City and in the  neurological institute in Austria.

Suitable patients with herniated disc were chosen and through a series of experiments the doses of energy were calculated. The laser was calibrated to deliver 10 - 20 watts at 1.0 second bursts to allow heat to dissipate.