The influence of Ho:YAG laser irradiation on intervertebral disc cells.

BACKGROUND AND OBJECTIVE

Various types of laser have been reported for percutaneous laser disc decompression (PLDD). The aim of this study was to understand the effects on intervertebral disc cells following Ho:YAG laser irradiation, using a three-dimensional culture model, and consider appropriate irradiation conditions.

STUDY DESIGN/MATERIALS AND METHODS: Intervertebral discs from the lumbar spine were obtained from 36 female Japanese white rabbits and processed to obtain isolated cells in three-dimensional cultures. Photoacoustic and photothermal effects were investigated by irradiating three-dimensional cultures with Ho:YAG laser at 27 or 54 J. Residual cell counts after irradiation were estimated based on DNA content according to fluorometric assay. Lactate dehydrogenase levels were also investigated as a marker of damage to cell plasma membranes. Finally, proteoglycan synthesis was measured by rapid filtration assay of (35) S incorporation, as an index of matrix synthesis.

RESULTS

Residual cell count tended to be higher in the 27-J group. Plasma membrane damage was higher and remained high longer after irradiation in the 54-J group. Proteoglycan synthesis was higher in the 27-J group than in the 54-J group, with some conditions (e.g., 90 mJ/pulse condition) showing marked activation of proteoglycan synthesis maintained for a long time after irradiation.

CONCLUSIONS

Three-dimensional culture models of intervertebral disc cells are useful for clarifying relationships between cell reactions and photoacoustic and photothermal effects after laser irradiation. Total energy is closely related to optimization of irradiation conditions, which may allow optimization of cytoprotection and promotion of matrix synthesis in clinical practice.