{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T20:56:45Z","timestamp":1762289805068,"version":"build-2065373602"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Symptomatic lumbar disc herniation is a major cause of low back pain and sciatica in adults, significantly affecting quality of life and creating economic burdens. Minimally invasive percutaneous intradiscal techniques, such as percutaneous laser disc decompression (PLDD), have been developed as alternatives to open surgery; however, their efficacy remains debated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, Setting, and Subjects<\/jats:title>\n                    <jats:p>This study evaluated the effectiveness of PLDD in patients with lumbar disc protrusions and contained herniations by assessing quantitative changes in herniated disc area on axial and sagittal MR images.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 58 patients with lumbar radiculopathy due to disc herniation underwent MRI two months after PLDD to evaluate changes in disc area. Axial and sagittal MR images with the greatest protrusion and neural compromise were analyzed, and patient pain severity, clinical outcomes, and satisfaction were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Results showed a statistically significant reduction in both axial and sagittal disc areas post-PLDD. The initial mean axial disc area of 0.51 cm2 (0.44-0.58) decreased to 0.29 cm2 (0.25-0.37), reflecting a median reduction of 35.9% (P\u2009&amp;lt;\u20090.0001). Similarly, the sagittal disc area decreased from a mean of 0.37 cm2 (0.33-0.43) to 0.19 cm2 (0.13-0.25), with a median reduction of 49.3% (P\u2009&amp;lt;\u20090.0001). All patients showed reductions in disc area, with a median reduction ratio of 52.7% (IQR: 45.2-56.2).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings suggest that PLDD is an effective option for reducing herniated disc size in carefully selected patients with contained disc herniations who have not responded to conservative treatment. Although not a substitute for open surgery, PLDD offers a statistically significant reduction in herniated disc size, making it a valuable therapeutic option for symptomatic contained lumbar disc herniation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/pm\/pnaf070","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T09:36:09Z","timestamp":1747992969000},"page":"741-748","source":"Crossref","is-referenced-by-count":0,"title":["Radiological analysis of herniated disc size changes after percutaneous laser disc decompression"],"prefix":"10.1093","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1356-1846","authenticated-orcid":false,"given":"Roberto","family":"Gazzeri","sequence":"first","affiliation":[{"name":"Interventional and Surgical Pain Management Unit, San Giovanni Addolorata Hospital , 00184 Rome,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felice","family":"Occhigrossi","sequence":"additional","affiliation":[{"name":"Interventional and Surgical Pain Management Unit, San Giovanni Addolorata Hospital , 00184 Rome,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcelo","family":"Galarza","sequence":"additional","affiliation":[{"name":"Regional Service of Neurosurgery, \u201cVirgen de la Arrixaca\u201d University Hospital , 30120 Murcia,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4321-6525","authenticated-orcid":false,"given":"Marco","family":"Mercieri","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University of Rome , 00100 Rome,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo Luigi Giuseppe","family":"Leoni","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University of Rome , 00100 Rome,","place":["Italy"]},{"name":"Unit of Interventional and Surgical Pain Management, Guglielmo da Saliceto Hospital , 0523 Piacenza,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,5,26]]},"reference":[{"issue":"3","key":"2025110415482043100_pnaf070-B1","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/s11916-019-0757-1","article-title":"Low back pain, a comprehensive review: pathophysiology, diagnosis, and treatment","volume":"23","author":"Urits","year":"2019","journal-title":"Curr Pain Headache Rep"},{"issue":"11","key":"2025110415482043100_pnaf070-B2","doi-asserted-by":"crossref","first-page":"2791","DOI":"10.1007\/s00586-018-5673-2","article-title":"Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview","volume":"27","author":"Oliveira","year":"2018","journal-title":"Eur Spine J"},{"issue":"1","key":"2025110415482043100_pnaf070-B3","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1097\/BRS.0b013e31815e3a42","article-title":"The outcomes of lumbar microdiscectomy in a young, active population: correlation by herniation type and level","volume":"33","author":"Dewing","year":"2008","journal-title":"Spine"},{"issue":"5","key":"2025110415482043100_pnaf070-B4","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1007\/s00776-011-0123-6","article-title":"Perioperative complications and adverse events after lumbar spinal surgery: evaluation of 1012 operations at a single center","volume":"16","author":"Imagama","year":"2011","journal-title":"J Orthop Sci"},{"issue":"8","key":"2025110415482043100_pnaf070-B5","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1097\/00007632-199208000-00014","article-title":"Percutaneous laser disc decompression A new therapeutic modality","volume":"17","author":"Choy","year":"1992","journal-title":"Spine"},{"issue":"6","key":"2025110415482043100_pnaf070-B6","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1093\/pm\/pnac188","article-title":"Ultrasound-guided Percutaneous Laser Disc Decompression (PLDD) with fluoroscopic validation for the treatment of cervical disc herniation: technical note","volume":"24","author":"Gazzeri","year":"2023","journal-title":"Pain Med"},{"issue":"3","key":"2025110415482043100_pnaf070-B7","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.surneu.2009.01.023","article-title":"Percutaneous endoscopic laser annuloplasty for discogenic low back pain","volume":"73","author":"Lee","year":"2010","journal-title":"World Neurosurg"},{"issue":"2","key":"2025110415482043100_pnaf070-B8","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.neurad.2021.09.004","article-title":"Intradiscal oxygen-ozone therapy for the treatment of symptomatic lumbar disc herniation: a preliminary study","volume":"49","author":"Simon","year":"2022","journal-title":"J Neuroradiol"},{"key":"2025110415482043100_pnaf070-B9","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/1471-2474-10-49","article-title":"Effectiveness of percutaneous laser disc decompression versus conventional open discectomy in the treatment of lumbar disc herniation; design of a prospective randomized controlled trial","volume":"10","author":"Brouwer","year":"2009","journal-title":"BMC Musculoskelet Disord"},{"issue":"13","key":"2025110415482043100_pnaf070-B10","doi-asserted-by":"crossref","first-page":"2164","DOI":"10.3390\/diagnostics13132164","article-title":"Intradiscal gelified ethanol nucleolysis versus endoscopic surgery for lumbar disc herniation radiculopathy","volume":"13","author":"Gogos","year":"2023","journal-title":"Diagnostics (Basel)"},{"issue":"6","key":"2025110415482043100_pnaf070-B11","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1016\/j.spinee.2021.11.017","article-title":"Intradiscal oxygen-ozone chemonucleolysis versus microdiscectomy for lumbar disc herniation radiculopathy: a non-inferiority randomized control trial","volume":"22","author":"Kelekis","year":"2022","journal-title":"Spine J"},{"key":"2025110415482043100_pnaf070-B12","first-page":"403","article-title":"Percutaneous laser disc decompression (PLDD) for the treatment of contained lumbar disc herniation","volume":"41","author":"Gazzeri","year":"2022","journal-title":"Surg Technol Int"},{"issue":"17","key":"2025110415482043100_pnaf070-B13","doi-asserted-by":"crossref","first-page":"5049","DOI":"10.3390\/jcm13175049","article-title":"Efficacy of Percutaneous Laser Disc Decompression (PLDD) combined with an oral food supplement for lumbar disc herniation","volume":"13","author":"Gazzeri","year":"2024","journal-title":"J Clin Med"},{"issue":"5","key":"2025110415482043100_pnaf070-B14","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1089\/pho.2004.22.434","article-title":"Percutaneous laser disc decompression for the treatment of discogenic lumbar pain and sciatica: a preliminary report with 3-month follow-up in a general pain clinic population","volume":"22","author":"McMillan","year":"2004","journal-title":"Photomed Laser Surg"},{"issue":"3","key":"2025110415482043100_pnaf070-B15","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1007\/s10103-016-1865-3","article-title":"Evaluation of different laser wavelengths on ablation lesion and residual thermal injury in intervertebral discs of the lumbar spine","volume":"31","author":"Plapler","year":"2016","journal-title":"Lasers Med Sci"},{"issue":"1","key":"2025110415482043100_pnaf070-B16","first-page":"232","article-title":"Percutaneous laser disk decompression: a review of the literature","volume":"27","author":"Schenk","year":"2006","journal-title":"AJNR Am J Neuroradiol"},{"issue":"14","key":"2025110415482043100_pnaf070-B17","doi-asserted-by":"crossref","first-page":"1650","DOI":"10.1097\/00007632-199707150-00025","article-title":"A prospective analysis of magnetic resonance imaging findings in patients with sciatica and lumbar disc herniation. Correlation of outcomes with disc fragment and canal morphology","volume":"22","author":"Carragee","year":"1997","journal-title":"Spine (Phila Pa 1976)"},{"issue":"7","key":"2025110415482043100_pnaf070-B18","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1177\/2192568219880822","article-title":"Does size matter? An analysis of the effect of lumbar disc herniation size on the success of nonoperative treatment","volume":"10","author":"Gupta","year":"2020","journal-title":"Global Spine J"},{"issue":"5","key":"2025110415482043100_pnaf070-B19","first-page":"E737","article-title":"Quantity of disc removal and radiological outcomes of percutaneous endoscopic lumbar discectomy","volume":"20","author":"Heo","year":"2017","journal-title":"Pain Phys"},{"issue":"7","key":"2025110415482043100_pnaf070-B20","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1007\/s00586-009-1274-4","article-title":"MSU classification for herniated lumbar discs on MRI: toward developing objective criteria for surgical selection","volume":"19","author":"Mysliwiec","year":"2010","journal-title":"Eur Spine J"},{"issue":"3","key":"2025110415482043100_pnaf070-B21","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1148\/radiol.14141400","article-title":"Herniated lumbar disks: real-time MR imaging evaluation during continuous traction","volume":"275","author":"Chung","year":"2015","journal-title":"Radiology"},{"issue":"6","key":"2025110415482043100_pnaf070-B22","doi-asserted-by":"crossref","first-page":"558","DOI":"10.4097\/kja.19087","article-title":"Multicollinearity and misleading statistical results","volume":"72","author":"Kim","year":"2019","journal-title":"Korean J Anesthesiol"},{"issue":"1","key":"2025110415482043100_pnaf070-B23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1089\/104454701750066866","article-title":"Percutaneous laser disc decompression (PLDD): a first line treatment for herniated discs","volume":"19","author":"Choy","year":"2001","journal-title":"J Clin Laser Med Surg"},{"issue":"5","key":"2025110415482043100_pnaf070-B24","first-page":"e59617","article-title":"Surgical vs. conservative management of chronic sciatica (&gt;3 months) due to lumbar disc herniation: systematic review and meta-analysis","volume":"16","author":"Hammed","year":"2024","journal-title":"Cureus"},{"issue":"9","key":"2025110415482043100_pnaf070-B25","first-page":"CD010328","article-title":"Minimally invasive discectomy versus microdiscectomy\/open discectomy for symptomatic lumbar disc herniation","volume":"2014","author":"Rasouli","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"issue":"2","key":"2025110415482043100_pnaf070-B26","first-page":"E149","article-title":"Nucleoplasty, a minimally invasive procedure for disc decompression: a systematic review and meta-analysis of published clinical studies","volume":"17","author":"Eichen","year":"2014","journal-title":"Pain Physician"},{"issue":"5","key":"2025110415482043100_pnaf070-B27","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1007\/s11547-022-01469-6","article-title":"Intradiscal ozone therapy: fluoroscopic guidance reduces operative time in comparison with CT guidance in patients with lumbar disc herniation","volume":"127","author":"Somma","year":"2022","journal-title":"Radiol Med"},{"issue":"4","key":"2025110415482043100_pnaf070-B28","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1089\/pho.2012.3402","article-title":"Efficacy evaluation of percutaneous laser disc decompression in the treatment of lumbar disc herniation","volume":"31","author":"Ren","year":"2013","journal-title":"Photomed Laser Surg"},{"key":"2025110415482043100_pnaf070-B29","doi-asserted-by":"crossref","first-page":"SE229","DOI":"10.36076\/ppj.2013\/16\/SE229","article-title":"Percutaneous lumbar laser disc decompression: an update of current evidence","volume":"16","author":"Singh","year":"2013","journal-title":"Pain Physician"},{"issue":"6","key":"2025110415482043100_pnaf070-B30","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1016\/j.spinee.2005.05.384","article-title":"Percent spinal canal compromise on MRI utilized for predicting the need for surgical treatment in single-level lumbar intervertebral disc herniation","volume":"5","author":"Carlisle","year":"2005","journal-title":"Spine J"},{"issue":"11","key":"2025110415482043100_pnaf070-B31","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1016\/j.jvir.2012.07.029","article-title":"Analysis of disk volume before and after CT-guided intradiscal and periganglionic ozone-oxygen injection for the treatment of lumbar disk herniation","volume":"23","author":"Lehnert","year":"2012","journal-title":"J Vasc Interv Radiol"},{"issue":"3","key":"2025110415482043100_pnaf070-B32","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1302\/0301-620X.105B3.BJJ-2022-1005.R2","article-title":"Incidence and risk factors for five-year recurrent disc herniation after primary single-level lumbar discectomy","volume":"105-B","author":"Geere","year":"2023","journal-title":"Bone Joint J"},{"issue":"3","key":"2025110415482043100_pnaf070-B33","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1002\/1522-2586(200009)12:3<439::AID-JMRI9>3.0.CO;2-J","article-title":"Sensitivity and specificity of dural sac and herniated disc dimensions in patients with low back-related leg pain","volume":"12","author":"Pneumaticos","year":"2000","journal-title":"J Magn Reson Imaging"},{"issue":"5","key":"2025110415482043100_pnaf070-B34","doi-asserted-by":"crossref","first-page":"647","DOI":"10.3171\/2011.1.SPINE10426","article-title":"Outcomes after incidental durotomy during first-time lumbar discectomy","volume":"14","author":"Desai","year":"2011","journal-title":"J Neurosurg Spine"},{"key":"2025110415482043100_pnaf070-B35","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.jocn.2018.01.008","article-title":"Evaluation and management of small dural tears in primary lumbar spinal decompression and discectomy surgery","volume":"50","author":"Galarza","year":"2018","journal-title":"J Clin Neurosci"},{"issue":"2","key":"2025110415482043100_pnaf070-B36","doi-asserted-by":"crossref","first-page":"E3","DOI":"10.3171\/foc.2002.13.2.4","article-title":"Lumbar microdiscectomy: a historical perspective and current technical considerations","volume":"13","author":"Koebbe","year":"2002","journal-title":"Neurosurg Focus"},{"issue":"4","key":"2025110415482043100_pnaf070-B37","doi-asserted-by":"crossref","first-page":"E6","DOI":"10.3171\/2015.7.FOCUS15281","article-title":"Lumbar microdiscectomy complication rates: a systematic review and meta-analysis","volume":"39","author":"Shriver","year":"2015","journal-title":"Neurosurg Focus"},{"issue":"1","key":"2025110415482043100_pnaf070-B38","first-page":"E45","article-title":"Incidence of spontaneous resorption of lumbar disc herniation: a meta-analysis","volume":"20","author":"Zhong","year":"2017","journal-title":"Pain Physician"},{"issue":"6","key":"2025110415482043100_pnaf070-B39","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1097\/BSD.0000000000001490","article-title":"Incidence of spontaneous resorption of lumbar disc herniation: a meta-analysis","volume":"37","author":"Zou","year":"2024","journal-title":"Clin Spine Surg"},{"issue":"4","key":"2025110415482043100_pnaf070-B40","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1097\/00007632-200002150-00014","article-title":"Effect of the transligamentous extension of lumbar disc herniations on their regression and the clinical outcome of sciatica","volume":"25","author":"Ahn","year":"2000","journal-title":"Spine (Phila Pa 1976)"},{"issue":"7","key":"2025110415482043100_pnaf070-B41","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1097\/00007632-199007000-00013","article-title":"The natural history of lumbar intervertebral disc extrusions treated nonoperatively","volume":"15","author":"Saal","year":"1990","journal-title":"Spine (Phila Pa 1976)"},{"issue":"2","key":"2025110415482043100_pnaf070-B42","doi-asserted-by":"crossref","first-page":"162","DOI":"10.5313\/wja.v3.i2.162","article-title":"Lumbar radiculopathy and its neurobiological basis","volume":"3","author":"Lin","year":"2014","journal-title":"WJA"},{"issue":"3","key":"2025110415482043100_pnaf070-B43","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/S1047-9651(02)00005-0","article-title":"Pathophysiology of inflammatory, degenerative, and compressive radiculopathies","volume":"13","author":"Lipetz","year":"2002","journal-title":"Phys Med Rehabil Clin N Am"}],"container-title":["Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/painmedicine\/advance-article-pdf\/doi\/10.1093\/pm\/pnaf070\/63355976\/pnaf070.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/painmedicine\/article-pdf\/26\/11\/741\/63355976\/pnaf070.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/painmedicine\/article-pdf\/26\/11\/741\/63355976\/pnaf070.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T20:48:33Z","timestamp":1762289313000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/painmedicine\/article\/26\/11\/741\/8149198"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,26]]},"references-count":43,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,5,26]]},"published-print":{"date-parts":[[2025,11,1]]}},"URL":"https:\/\/doi.org\/10.1093\/pm\/pnaf070","relation":{},"ISSN":["1526-2375","1526-4637"],"issn-type":[{"type":"print","value":"1526-2375"},{"type":"electronic","value":"1526-4637"}],"subject":[],"published-other":{"date-parts":[[2025,11]]},"published":{"date-parts":[[2025,5,26]]}}}