Laser decompression is the use of high temperatures (up to 200°C locally) to ablate or vaporize the nucleus pulposus tissue within the disc, resulting in a reduction in volume and a decrease in intradiscal pressure. Studies have shown that smaller volume changes within the disc can lead to larger pressure changes, and pressure studies on discs in fresh human specimens have shown that the average decrease in intradiscal pressure after laser vaporization is 156.09 ± 68.78 Kpa. Laser ablation generally forms an elliptical cavity within the disc along the long axis of the fiber, and the authors’ experiments and data show that the long-axis diameter of the elliptical cavity within the nucleus pulposus is determined by the exposed fiber The experiments and data show that the long-axis diameter of the oval cavity in the nucleus pulposus is determined by the length of the exposed fiber, while the short-axis diameter is controlled by the total energy of the laser light delivery, with a maximum cross-sectional area of 5mm×2mm when the length of the exposed fiber is 5mm and the total energy is 640J, and a maximum cross-sectional area of 10mm×3.5mm when the length of the exposed fiber is 10mm and the total energy is 1000J. This experimental data has guiding significance when designing parameters for laser treatment of cervical and lumbar discs. (A) equipment and materials 1, X-ray imaging equipment: high-definition X-ray machine capable of lumbar spine frontal and lateral television fluoroscopy, C-arm X-ray machine is preferred; 2, X-ray machine room: sterilization equipment, good ventilation, preoperative hand washing preparation room; 3, power not less than 15W semiconductor laser machine; 4, optical fiber; 5, lumbar intervertebral disc puncture needle that can pass through the optical fiber; 6, Y-joint ( 6. Y-type connector (connected to the puncture needle); 7. 20ml empty needle or pressure pump. (B) Indications Restrictive lumbar disc herniation (bulging, the annulus fibrosus is not broken, or the disc annulus fibrosus has not been completely ruptured disc pressure? Ozone experiment, ozone injection does not go in for decompression. discography direct evidence, but troublesome. ct can roughly determine the bulge or herniation, mri can better show the simple fibrous annulus? (C) contraindications 1, lumbar disc prolapse, nucleus pulposus tissue into the spinal canal; 2, disc degeneration, significant narrowing of the intervertebral space; 3, hypertrophy of the ligamentum flavum, bony spinal stenosis, narrowing of the lateral saphenous fossa; 4, lumbar disc herniation calcification or ossification; 5, lumbar slipped IIo or more; 6, recurrence after surgery with adhesions; 7, patients with mental abnormalities, too young or too old to cooperate with treatment; 8, patients with serious Patients with serious organic disorders that cannot tolerate treatment. (D) operation methods and steps 1, turn on the 15W semiconductor laser machine power supply, adjust the required indicators, using the intermittent pulse method, exposure 1S, intermittent 1S. 2, the fiber end connected to the laser generator, the other end of the fiber through the Y-joint through the lumbar needle, more than the tip of the needle 3-5mm?，the exposed tip of the fiber outer membrane stripped, and the Y-joint fixed in the fiber, start the test light source, the fiber emits a red ring of light. The fiber emits a red ring aperture, the fiber is normal standby state. Then remove the fiber from the lumbar puncture needle with the Y-joint. 3, the patient lies prone on the examination table, the abdomen is padded with a pillow, the puncture point is located by fluoroscopy, the corresponding vertebral space is 8-10 cm next to the midline, and the skin is marked with gentian violet. 4, local skin disinfection spread sterile towel, with 1% lidocaine for local anesthesia. 5, puncture with lumbar intervertebral disc puncture needle through the marking point and lumbosacral at an angle of 45o ~ 60o to the corresponding intervertebral space, L5-S1 still need to tilt 20o ~ 25o angle to the cephalad, when the needle tip into the intervertebral disc fiber ring, there is astringent feeling, through the fiber ring after the feeling of falling. 6, needle tip location: orthogonal fluoroscopy needle tip is located near the midline, lateral fluoroscopy needle tip is located in the disc in the posterior 1/3 junction. 7. The fiber optic fixed with Y-joint is slowly fed into the nucleus pulposus along the puncture needle, and the Y-joint is fixed by connecting it to the puncture needle. 8. Foot on the laser machine switch for pulpal nucleus vaporization. During the process, the patient is frequently asked whether there is any heat and swelling in the lumbar region, and when there is heat and swelling, the foot brake is released to rest, and the hyperthermic gas is extracted with an empty needle through the Y-joint. The total energy was controlled at 600 to 1800(?) depending on the patient’s height and weight. joules or so. Do not exceed 1000 joules? 9. Turn off the power at the end of treatment, remove the fiber, pull out the puncture needle, and dress the needle eye with a band-aid. (E) Postoperative reactions and treatment 1. Return to the ward and rest in bed for 5-7 days. 2. Postoperative patients rest in bed. 3. The postoperative reaction is mild, with only slight heat and swelling pain, which can disappear on its own without special treatment. Postoperative care 1. The injection site should be covered with sterile gauze, and the dressing should be kept dry and clean for 24h to prevent needle eye infection. 2.After lumbar PLDD surgery, you have to lie flat for 6h before lying on your side, you can get up and go down for 24h, and you can take a bath for 48h. 3, postoperative antibiotics as prescribed by the doctor to prevent infection. 4.Posture care: bed rest for 3 days after surgery, can lie down, prone or side lying. 5.Observation of pain: if the patient’s pain site is the same as before surgery, but to a lesser extent; if there is burning pain in other areas, it may be caused by intraoperative stretching, do not be nervous, it can be eliminated by itself in 3-5 days; if the patient has severe pain in the lumbar region, with progressive aggravation, and bed activity is obviously limited, it is mostly due to intervertebral infection, and should be treated symptomatically in time.