Technical Note: PDF OnlyEpstein Nancy E.Journal of SPINAL DISORDERS: February 1999 - p 77-79 Buy Abstract Summary An internist performed percutaneous laser-assisted diskectomies (PLADs) on a patient with a sequestrated disc and stenosis. Subspecialists who perform PLADs should be trained in patient selection and lumbar diskectomy techniques. Chymopapain, percutaneous nucleotome-assisted diskectomy, and PLADs are alternatives to microdiskectomy for the management of lumbar disc herniations. PLADs were performed at the L4–5/L5-S1 levels in a 38-year-old woman with magnetic resonance (MR)-documented L4–5 stenosis and disc disease. After PLADs, she developed a subacute cauda equina syndrome. Two months later, a neurosurgeon performed an L4–5 coronal hemilaminectomy with diskectomy. Within 6 postoperative weeks, she was neurologically intact. Only specialists trained in the selection, neurodiagnostic, and surgical management of lumbar disc disease should perform PLADs. © 1999 Lippincott Williams & Wilkins, Inc.