PERCUTANEOUS LASER DISC ABLATION

Percutaneous laser disc ablation (PLDA) is a minimally invasive prophylactic procedure used to prevent intervertebral disc ruptures. Type I intervertebral disc disease (IVDD) is a common neurological problem in chondrodystrophic breeds (Dachshund, Beagle, Basset Hound, Shih Tzu, etc…). The nucleus (middle portion) of the disc ruptures through the annulus (outer portion) and compresses the spinal cord. The spinal cord compression can cause a variety of symptoms including back pain, weakness and even paralysis and may require emergency surgery. The goal of PLDA is to ablate (vaporize) the nucleus to prevent other discs from rupturing.

The best candidates for PLDA include chondrodystrophic breeds with a history of IVDD. Dogs that have had IVDD treated medically (cage rest, steroids, NSAID’s) or surgically (hemilaminectomy) are both candidates for PLDA. The recurrence rate for dogs with IVDD treated medically is 31-50%. The recurrence rate for dogs treated surgically varies depending on multiple factors but is approximately 19%. Dachshunds that have had IVDD surgery have a higher recurrence rate of 25%. Once dogs have had PLDA, their recurrence rate drops to only 3%. Dogs that have never had an episode of IVDD can also be candidates for this procedure if their risk factors justify it.

In addition to the effectiveness of the procedure, it is also minimally invasive. Patients are anesthetized for the procedure. Using the guidance of a fluoroscope (real time x-ray machine), needles are placed into the nucleus of the disc. A small laser fiber is then placed through the needle into the nucleus and activated for 40 seconds. All of the discs in the thoracolumbar spine that commonly rupture are ablated. This will usually include discs from T10-11 through L5-6. PLDA can also be performed in the cervical spine for dogs that have had cervical IVDD.

Currently candidates for the procedure should be non-painful and must be off of all pain medications and anti-inflammatories for a minimum of two weeks. A minimum waiting period of one month should be allowed after a rupture is treated either medically or surgically. Following PLDA, dogs can go home the next day and should be restricted from running, jumping, and rough play for two weeks. Following the two weeks of restriction dogs can return to normal activity. Criteria for performing PLDA may change as new research dictates.

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