The effectiveness of laser autoplasty of the pulpous nucleus of the intervertebral disc in degenerative-dystrophic diseases of the spine

Degenerative spine diseases (DSD) are a leading cause of chronic low back pain and disability. Existing conservative and surgical methods often fail to address the root cause of pain and are associated with risks.
This study aimed to evaluate the clinical efficacy and safety of a minimally invasive method of laser autoplasty of the nucleus pulposus in patients with chronic pain syndrome.
Materials and methods. A prospective single-center study was conducted with 20 patients. Inclusion criteria: chronic non-radicular pain or radiculopathy in the irritation phase due to disc degeneration of stages I-III according to a classification (Pfirrmann). Under X-ray control, laser exposure (diode laser, 1061 nm) was
applied to three zones of the nucleus pulposus. Outcomes were assessed before surgery, after, and at 3- and 12-months using VAS, ODI, DN4, PainDetect, SF-36, HADS scales, and MRI of spine.
Results. A significant reduction in low back pain intensity (VAS: from 4.8±1.2 to 1.25±1.11 at 12 months, p<0.001) and improvement in functional status (ODI: from 15.15±4.87 to 5.88±4.28, p=0.0056) were observed. The proportion of patients with neuropathic pain decreased from 30% to 10%. Quality of life (SF-36) scores significantly improved, and levels of anxiety and depression (HADS) decreased. No complications were recorded.
Conclusion. Laser autoplasty of the nucleus pulposus is a highly effective and safe method for treating chronic pain syndrome in patients with stages I-III DSD, providing significant and sustained clinical improvement despite the lack of confirmed long-term structural disc restoration. The method can be considered a promising alternative to more invasive interventions.

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