PriMera Scientific Medicine and Public Health - 2 September 2022
Laser and Radiofrequency Energy Applications in the Percutaneous Endoscopic Surgical Treatment of Degenerative Disc Disease: Should be abandoned?
The word LASER stands for Light Amplification by Stimulated Emission of Radiation. According to this abbreviation that summarizes the energy generation; it is the light that occurs when the crystal between two full and semi reflective mirrors is exposed to intensified energy amplification the type of laser is named with the substance in the liquid crystal [1, 2]. Laser was first applied in the musculoskeletal system w by Whipple in 1984 using C02 laser. Classification according to the laser optic parameters (wavelength, power and dose) was developed in clinical trials after that date [1, 3]. Laser is known to change cell proliferation, motility and secretion at different doses. Tissue interaction can occur in the form of destruction, liquification, heating and evaporation depending on dose. The type of laser commonly used for the musculoskeletal system is resonance type which can be classified as follows [2]; 1. UV Laser (Excimer). 2. Visible Laser (Argon). 3. IR Laser (Ionization Resonance). C02 YAG: (Yttrium-Aluminum Garnet) o Neodmium o KTP Doubled Neodmium (Potassium-titanyI-Phosphate) o Holmium, Erbium. Argon laser is absorbed well by hemoglobin and creates effect by exerting heat in the tissue. This effect results in the apoptosis after oxygen is activated in cell nucleus. This is the basis of photodynamic treatment. Excimer does not create heat, breaks molecular connections; that’s why it is called cold laser. With C02, high power is generated at low frequencies, it is absorbed by water. Superficial effect occurs without penetration. Nd YAG has the highest penetration and coagulation effect.