1. 2018;21;E643-E650Safety and Effectiveness of Transforaminal Epiduroscopic Laser Ablation in Single Level Disc Disease: A Case-Control Study
   Case Control Study
   Gyu Yeul Ji, MD, Jongsun Lee, MD, PhD, Sang Won Lee, MD, PhD, Bo Young Cho, MD, PhD, Dong Won Ha, MD, Young Mok Park, MD, and Dong Ah Shin, MD, PhD.

BACKGROUND: The non-operative treatment of herniated intervertebral discs has long been a fundamental challenge. A novel technique of laser ablation to ablate the nucleus pulposus under a transforaminal epiduroscope (TELA system, Lutronics, Seoul, Republic of Korea) was recently developed.

OBJECTIVE: The purpose of this study was to evaluate the safety and effectiveness of transforaminal epiduroscopic laser ablation (TELA) for selective ablation of the nucleus pulposus in single-level disc disease.

STUDY DESIGN: Prospective case control study

SETTING: Multicenter study

METHODS: This study included a group of 56 patients who underwent transforaminal epiduroscopic laser ablation (TELA) and 56 patients who underwent selective transforaminal epidural block (STEB) for single-level disc disease. Visual analog scale (VAS), Oswestry Disability Index (ODI), and SF-12 were assessed at admission and at 1, 3, 6, and 12 months postoperatively.

RESULTS: The mean VAS of back pain was lower for the TELA group than for the STEB group 12 months postoperative (P < 0.05). The mean ODI was lower in the TELA group than in the STEB group at 12 months postoperatively (P < 0.05). There were no major complications related to the TELA and STEB procedures.

LIMITATIONS: The primary limitation is a small sample size. The control group was created from a database which was prospectively collected in a different time line.

CONCLUSIONS: The TELA procedure is superior to the STEB procedure in terms of patients reporting less pain and better quality of life over a year. TELA may be a reasonable alternative to conventional interventions or open surgery in single-level disc disease.

KEY WORDS: Laser-assisted spinal endoscopy, disc decompression, Nd:YAG laser, laser ablation, intervertebral disc disease, lumbar spine