The aim of percutaneous intradiscal laser ablation (also commonly referred to in the literature as percutaneous laser disc decompression) is to vaporise part of a prolapsed disc. It can only be carried out if the prolapse is contained (that is, the disc is bulging but the nucleus pulposus has not extruded through the annulus fibrosus).
The procedure is usually carried out under local anaesthesia and sedation, with the patient on their front. Under fluoroscopic guidance, a spinal needle is inserted through the annulus fibrosus into the nucleus pulposus, and an optical fibre is introduced through the needle. Laser energy is then delivered through the optical fibre to vaporise part of the nucleus pulposus.
Several types of laser are available for this procedure.