# Laser Reconstruction of Spinal Discs Experiments and Clinic
### Lasers in Spine Surgery
The thermal effect of laser radiation leads to de-reception of the disc and the effect of \"compression\", which ensures a decrease in the size of the protrusion. Moreover, the replacement of degeneratively destroyed IVD areas with new regenerating cartilaginous tissue limits the expansion of the innervation zone in the disc and thereby eliminates the development of discosgenic reflex pain syndromes [33; 34; 35]. Currently, among neurosurgeons and orthopedists, there are two opposing points of view on the possibilities, advantages, and disadvantages of ablative laser technology for the treatment of IVD. Along with a critical but generally positive assessment of the results of laser surgeries, the technology of which goes through various stages of development, a skeptical assessment of the prospects for the use of ablative lasers in spinal surgery has received a certain spread. The authors of [36] write: \"Despite the fact that lasers have long been used in pain treatment procedures such as percutaneous disccectomy, the alleged benefits of lasers, such as reducing inflammation and degeneration, have not been supported by reliable clinical studies.\" On the other hand, the authors of [37] note that after a 2-year follow-up, the strategy of laser percutaneous disk decompression by results is not inferior to microdiscetomy and, as a minimally invasive method, can take its place in the arsenal of treatment for radiculitis caused by herniated IVD. An example of a negative assessment of ablative laser surgery is the work [38], which notes that several randomized clinical trials have shown the lack of clinical efficacy of PLD-type procedures compared to microdiscectomy. It is noted that laser procedures are often performed by pain specialists without special surgical experience who are unable to eliminate the postoperative complications of PLD. There are doubts about the feasibility of using PLD for the treatment of minimal disc herniation, since such patient problems often resolve spontaneously within a few months without surgery. In a recent review article on the use of lasers in neurosurgery [39], the following conclusion was formulated: \"The many ways in which lasers are used in neurosurgery are evidence of the technological advances and practicality of laser science. Despite the difference of opinion, the use of lasers for minimally invasive procedures shows promising results and deserves further study.\"  
It should be emphasized that the above doubts relate mainly to destructive operations on the IVD using ablative laser radiation. The authors of negative statements did not consider the new restorative technology of LRD, which eliminates the adverse consequencesassociated with damage to surrounding tissues [31; 32; 33; 34; 35]. In contrast to ablation technologies, the use of moderate radiation powers in LRD allows non-destructive modification of the tissue microstructure. For the processes of laser modification, the correct choice of parameters is especially important, which makes it possible to control the ongoing physicochemical and biological processes by controlling the temperature and thermomechanical stresses in the laser treated zone. This makes it possible to obtain a stable positive effect of LRD [33; 35].