J Clin Laser Med Surg. 2002 Dec;20(6):341-3.
Contraindications in noninvasive laser therapy: truth and fiction.
Navratil L, Kymplova J.
University of South Bohemia, Faculty of Social and Health Studies, Section of Radiobiology and Toxicology, Department of Radiology, Ceske Budejovice, Prague, Czech Republic. firstname.lastname@example.org
OBJECTIVE: Noninvasive laser therapy is a treatment method employed in many disciplines. This review article points out instances when it appears to be effective to administer such therapy. MATERIALS AND METHODS: Noninvasive laser therapy has a number of suitable applications that cause minimal damage to the patient. Many patients are not sent to institutions equipped with relevant instruments, since physicians are burdened by a number of contraindications, many of which are incorrect. The purpose of this article was to divide these contraindications into the following three groups: correct indications, indications doubtful under certain conditions, and incorrect indications. DISCUSSION: We consider the following contraindications as correct: history of a histologically demonstrated malignant carcinoma; irradiation of the neck region in hyperthyreosis; epilepsy; exposure of the retina; and exposure of the abdomen during pregnancy. The contraindications that are doubtful under certain conditions are as follows: fever and infectious diseases; certain blood diseases; heavy blood losses; neuropathies; and irradiation in the region of gonads. The other contraindications reported in the literature are considered to be incorrect.
Ortop Traumatol Rehabil. 2004 Jun 30;6(3):314-8.
Percutaneous laser lumbar disc decompression – mechanism of action, indications and contraindications.
Maksymowicz W, Barczewska M, Sobieraj A.
This article describes the development of minimally invasive methods in the treatment of lumbar discopathy, with particular attention to percutaneous laser disc decompression (PLDD). The authors discus the therapeutic operating mechanism of PLDD, emphasizing the importance of the thermal characteristics of laser light, which is responsible for the vaporization and ablation of a small amount of tissue from the nucleus pulposus. This causes a significant reduction in pressure in the closed structure of the disc, and consequently reduced compression exerted by the disk on the dural sac and the nerve roots. Improvement in the flow of cerebro-spinal fluid has also been observed on the level at which the operation is performed. On the basis of our own experience and the reports of other authors, we have specified indications and contra-indications for PLDD. Our conclusion is that PLDD is an effective treatment method for low back pain and ischialgia caused by protrusion or herniation of the nucleus pulposus, with elimination or significant reduction in symptoms in over 75% of those treated; reduction or resolution of neurological deficits that arise in the course of lumbar discopathy has also been observed. This method enables one-stage treatment of multi-level degenerative changes in the intervertebral disc. The only absolute contraindications for PLDD are the presence of sequestration, disturbances in blood coagulation, and bacterial infection.