Percutaneous laser disc decompression (PLDD) update: focus on device and procedure advances.

This discussion is an update on the U.S. advances in percutaneous laser disc decompression (PLDD). This report summarizes the knowledge that has been gained about the procedure, advances in technique, and increased information about the three lasers currently in use for PLDD: KTP, Nd:YAG, and holmium. A new surgical approach to the L5-S1 disc is described. It is concluded that PLDD has become an established procedure that will be more widely used because it is simple, effective, and reasonably safe.