PETD with laser is a minimally invasive surgical treatment for symptomatic thoracic disc herniation (TDH). It may also be known as: posterolateral thoracic discectomy; endoscopic laser thoracic discectomy; or endoscopic microdecompressive thoracic discectomy with laser thermodiscoplasty.
Symptomatic TDH is rare accounting for between 0.25% and 0.57% of all disc herniations reported in the literature. Symptoms include back pain, radicular pain, nondermatomal leg pain, bladder dysfunction, and lower extremity weakness. If left untreated serious neurological sequelae may occur.
The procedure is similar to percutaneous laser discectomy for the lumbar and cervical spine, and aims to decompress the disc using a percutaneous needle and laser ablation.
Percutaneous endoscopic laser thoracic discectomy is purported to reduce morbidity
and promote earlier return to work, and result in less scarring than other techniques.
Other likely advantages are that it does not interfere with the bones or joints of the
spine or require manipulation of nerves or the spinal cord.
The steep learning curve for endoscopic techniques, the high cost of specialized instrumentation and the relatively low incidence of suitable surgical candidates are all factors contributing the to the very small number of surgeons who appear to be using this technique at present.
Open Thoracic Microdiscectomy
Thoracic corpectomy and fusion
Thorascopic discectomy