Use of holmium laser energy for vaporization/coagulation of the nucleus pulposus in canine intervertebral discs has been previously reported and is currently being applied clinically in veterinary medicine. The procedure was originally developed in the canine model and intended for potential human use. Since the pulsed (15 Hz) holmium laser energy exerts photomechanical and photothermal effects, the potential for extrusion of additional disc material to the detriment of the patient is possible using the procedure developed for the dog. To reduce this potential complication, use of diode laser (805 nm - CW mode) energy, coupled with indocyanine green (ICG) as a selective laser energy absorber, was formulated as a possible alternative. Delivery of the ICG and diode laser energy was through a MicroJet device that could dispense dye interactively between individual laser 'shots.' Results have shown that it is possible to selectively ablate nucleus pulposus in the canine model using the device described. Acute observations (gross and histopathologic) illustrate that accurate placement of the spinal needle before introduction of the MicroJet device is critically dependent on the expertise of the interventional radiologist. In addition, the success of the overall technique depends on consistent delivery of both ICG and diode laser energy. Minimizing tissue carbonization on the tip of the MicroJet device is also of crucial importance for effective application of the technique in clinical veterinary medicine.

Date Published: 1 July 1998
PDF: 7 pages
Proc. SPIE 3245, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems VIII, (1 July 1998); doi: 10.1117/12.312310

Published in SPIE Proceedings Vol. 3245:
Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems VIII
Graham M. Watson M.D.; Harvey Lui M.D.; Lou Reinisch; Penny J. Smalley R.N.; Kenneth Eugene Bartels D.V.M.; R. Rox Anderson M.D.; Lawrence S. Bass M.D.; Kenneth Eugene Bartels D.V.M.; C. Gaelyn Garrett M.D.; Lloyd P. Tate V.D.M.; Sharon L. Thomsen M.D.; Reza S. Malek M.D.; Aaron P. Perlmutter M.D.; R. Rox Anderson M.D.; Lawrence S. Bass M.D.; C. Gaelyn Garrett M.D.; Kenton W. Gregory M.D.; Harvey Lui M.D.; Reza S. Malek M.D.; Aaron P. Perlmutter M.D.; Lou Reinisch; Penny J. Smalley R.N.; Lloyd P. Tate V.D.M.; Sharon L. Thomsen M.D.; Graham M. Watson M.D., Editor(s)