Laser Reconstruction of Intervertebral Disks

E.N. Sobol1, A.V. Baskov2, A.B. Shekhter4, I.A. Borshchenko3, O.L. Zakharkina1, V.A. Baskov4, I.Yu. Kolyshev4

(1 Institute of Laser and Information Technologies of the Russian Academy of Sciences, Troitsk;
2 The Faculty of Neurosurgery of the Russian Medical Academy of Postgraduate Education, Moscow;
3 Medical Center of Vertebrology and Orthopedics, Moscow;
4 Sechenov Moscow Medical Academy, Moscow)

Laser reconstruction of intervertebral disks (LRID) is a new minimum-invasive method for treatment of their diseases. The essence of a new approach lies in local modification of a structure and stress fields in a cartilage with the help of a non-destructive laser impact, providing controllable regeneration of a cartilaginous tissue and a long-term anesthetic effect. A pulsed fiber erbium-doped glass laser with a wavelength of 1.56 µm was used in experiments on animals and clinical studies. The experiments were carried our on disks of 48 rabbits. Dynamics of a temperature field was estimated with a fiber radiometer and a thermocouple, introduced into a pulpous nucleus. Structural changes within rabbits’ tissue were studied before and immediately after a laser impact, as well as in 3, 7, 14, 40 days and 2, 3 months. It was done with use of histological and histochemical methods, optical coherent tomography and an atomic microscope. Clinical studies were carried out on 160 cases, aged 22-64 (a mean age of 45 years). A follow-up period was 12 months. The experiments on rabbits demonstrated a non-destructive character of a laser impact. Signs of regenerative processes were watched in 3-7 days after irradiation. A new tissue grew in a zone of irradiation in 1-2 months. It was represented either by a hyaline cartilage (in mild modes of irradiation) or by a fibrous tissue (in tough modes of irradiation, leading to tissue denaturation). Studies with an atomic microscope and optical coherent tomography revealed acceleration of fluid motion in a zone of a laser impact. It was connected with heterogeneous heating up to 50o C and formation of micropores, promoting increase of water metabolism and nutrition of tissue cells. Later the method under discussion was probated in a clinic for treatment of patients with degenerative diseases of intervertebral disks. Clinical trials were indicative of positive results, watched in the overwhelming majority of cases. A good effect of LRID manifested itself 2 months after intervention. It became stable in 6 months. Considerable reduction of pain syndrome was achieved in 96% of cases; 92% of patients returned to their work and active life.