{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T06:52:58Z","timestamp":1789195978411,"version":"build-2803163510"},"reference-count":31,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2017,4,28]],"date-time":"2017-04-28T00:00:00Z","timestamp":1493337600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Healthcare Insurance Board of the Netherlands"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Interv Neuroradiol"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Percutaneous laser disc decompression is a minimally invasive treatment, for lumbar disc herniation and might serve as an alternative to surgical management of sciatica. In a randomised trial with two-year follow-up we assessed the clinical effectiveness of percutaneous laser disc decompression compared to conventional surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This multicentre randomised prospective trial with a non-inferiority design, was carried out according to an intent-to-treat protocol with full institutional review board approval. One hundred and fifteen eligible surgical candidates, with sciatica from a disc herniation smaller than one-third of the spinal canal, were randomly allocated to percutaneous laser disc decompression ( n\u2009=\u200955) or conventional surgery ( n\u2009=\u200957). The main outcome measures for this trial were the Roland-Morris Disability Questionnaire for sciatica, visual analogue scores for back and leg pain and the patient's report of perceived recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The primary outcome measures showed no significant difference or clinically relevant difference between the two groups at two-year follow-up. The re-operation rate was 21% in the surgery group, which is relatively high, and with an even higher 52% in the percutaneous laser disc decompression group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>At two-year follow-up, a strategy of percutaneous laser disc decompression, followed by surgery if needed, resulted in non-inferior outcomes compared to a strategy of microdiscectomy. Although the rate of reoperation in the percutaneous laser disc decompression group was higher than expected, surgery could be avoided in 48% of those patients that were originally candidates for surgery. Percutaneous laser disc decompression, as a non-surgical method, could have a place in the treatment arsenal of sciatica caused by contained herniated discs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1591019917699981","type":"journal-article","created":{"date-parts":[[2017,4,29]],"date-time":"2017-04-29T01:36:54Z","timestamp":1493429814000},"page":"313-324","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":36,"title":["Percutaneous laser disc decompression versus conventional microdiscectomy for patients with sciatica: Two-year results of a randomised controlled trial"],"prefix":"10.1177","volume":"23","author":[{"given":"Patrick A","family":"Brouwer","sequence":"first","affiliation":[{"name":"Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands"},{"name":"Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Brand","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics and BioInformatics, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M Elske","family":"van den Akker-van Marle","sequence":"additional","affiliation":[{"name":"Department of Decision Making, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilco CH","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry","family":"Schenk","sequence":"additional","affiliation":[{"name":"Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette A","family":"van den Berg-Huijsmans","sequence":"additional","affiliation":[{"name":"Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart W","family":"Koes","sequence":"additional","affiliation":[{"name":"Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A","family":"Arts","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands"},{"name":"Department of Neurosurgery, Medical Center The Hague, The Hague, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MA","family":"van Buchem","sequence":"additional","affiliation":[{"name":"Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilco C","family":"Peul","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands"},{"name":"Department of Neurosurgery, Medical Center The Hague, The Hague, The 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