# Laser Reconstruction of Spinal Discs Experiments and Clinic
## 5 Conclusions  
Summing up the results of many years of painstaking work of a large team of physicists, biologists, morphologists, orthopedists, and neurosurgeons who have studied the possibilities of regeneration of cartilaginous tissue--the most complex and rigid body structure, we can say with confidence that a significant contribution has been made to the regenerative medicine. The laser turned out to be a powerful stimulator of tissue regeneration. New, previously unknown parameters of a modifying non-destructive effect on tissues have proven to be very effective for the restoration of degeneratively altered intervertebral discs. These changes in the disc underlie DDD. Thus, by stimulating the process of IVD regeneration, it is possible to prevent the development of DDD. Based on numerous experimental and clinical studies, the optimal laser has been selected. It turned out to be a 1560 nm Er fiber laser. It penetrates sufficiently deep into tissues with adequate parameters (power, duration, and pulse repetition rate) upon exposure, it does not destroy tissues and helps to restore the nutrition of disc tissues, restoring pores in hyaline cartilage and stimulating the activity of chondrocytes and stem cells. As a result, the ruptures of the AF are quickly replaced by hyaline cartilage, which closes its defects, preventing the recurrence of disc herniation. In place of the destroyed NP, a new (first described) type of cartilage tissue is formed, fibrohyaline cartilage, which has both elasticity and high strength as well as resistance to stress. This newly formed cartilage significantly reduces the instability of the segment, which helps to reduce the stress on the joints, stopping the development of the degenerative process in the spine. Within 3-6 months, almost 90% of patients restore their quality of life, they can play sports and enjoy an active lifestyle without disease recurrence. Amazingly, this requires a one-time treatment procedure. At present, more than five thousand patients have been treated with LRD, including more than three thousand patients with spine DDD who had the puncture-type surgeries, Most of these patients are young, of active age and demonstrated excellent clinical results. MRI examinations make it possible to see and thus objectify the process. restoration of structural formations of the IVD and facet joints. The method of LRD allows us to reduce the likelihood of recurrence of disc herniation after microdiscectomy by several times (from 4 to 1%) and this percentage is practically zero during puncture or endoscopic removal of a disc herniation. In last 15 years, the combination of removal of a herniated disc with laser reconstruction has been used in more than two thousand patients.  
Of course, this new method of treatment requires further studying and improvement, but now it has already begun to be used in the treatment of degenerative lesions of large joints. Preliminary results show its safety and efficacy, which makes it possible to use it in the early stages of osteoarthritis, which in the future will significantly reduce the number of prostheses for large joints.  
Conceptualization, A.B., A.S. and E.S.; theoretical investigations E.S.; experiential animal investigations A.B., V.B., I.A.B. and E.S.; clinical study, A.B., I.A.B. and V.B.; histological investigation, A.S.; writing--original draft preparation, A.B. and E.S. All authors have read and agreed to the published version of the manuscript.  
This research received no external funding.  
The Independent Interdisciplinary Committee on Ethical Experiments, Moscow, Russia approved the Clinical Study \"Laser Reconstruction of Intervertebral Discs\", Approval No. 13, 16 August 2019.  
The authors declare no conflict of interest.