# Laser Reconstruction of Spinal Discs Experiments and Clinic
### Modern Methods of Treatment of Degenerative Disc Diseases  
Treatment of DDD is usually based on surgical methods or conservative therapy, including medical pain relief and the use of physiotherapy methods of treatment. Conservative therapy, used for several years, leads to a decrease in pain, but also leads to the appearance of IVD fibrosis. At the same time, the persisting overload of the facet joints of the spine and the phenomena of instability form a new pain syndrome [5]. The use of modern surgical technologies for the treatment of DDD, unfortunately, does not stop the pathological process, but serves as a palliative method that temporarily relieves pain and temporarily improves the patient's quality of life. Surgical interventions lead to the subsequent decompensation of the process and weaken the compensatory capabilities of the organism itself. Therefore, at present, there is an active search for new methods of treating DDD, and colossal funds are spent on research in this area [6]. Thermal inactivating pain receptors in IVD is carried out by percutaneous radiofrequency (RF) thermo-coagulation or intradiscal electro thermotherapy (IDET) [7; 8; 9; 10]. RF and IDET methods do not stimulate  
Figure 1: Structure and problems of the spinal disc: (**A**) main components of the disc; (**B**) the sequence of the development of degenerative disc diseases.  
biological disc remodeling and repair. After some time, the pain syndrome progresses again [11; 12; 13]. Various methods of nucleotomy have become another area of intradiscal decompression [14]. Some authors suggested that fenestration and partial removal of IVD material would reduce intradiscal pressure and nerve root irritation. For this, both endoscopic and puncture access were used, with various types of nucleotomes under X-ray control. Despite the low invasiveness, cost and comparative safety of puncture techniques, the problem of relapses, postoperative instability, and low efficiency (60-70%) of such operations remains. During long-term follow-up from 5 to 25 years for patients after open classical discectomy, based on radiological changes, acceleration of disc degeneration was noted in 48.7% of cases. Microsurgical technique reduces this risk, provoking negative changes in 9.1% [15]. One of the problems, especially in the case of operations aimed at removing a hernia, is a recurrent herniated disc, which can reach 10-15% of operated cases [16; 17]. The implants used to close the defects of the AF designed to reduce the number of relapses did not confirm their effectiveness in the long-term period after surgery [18].  
At the beginning of the 21 st century, fusion and implantation operations became widespread [19]. However, there are randomized studies that show that the placement of implants increases the risk of undesirable effects (nerve damage, blood loss, inflammatory and general complications), while increasing the time of surgery and the risk of revision spine surgeries [20; 21].  
In recent years, attempts to counteract degenerative disc damage is also associated with biological methods with intradiscal stem cell transplantation. Despite some laboratory advances, the clinical use of stem cell transplantation has led to mixed results. In particular, after transplantation of one's own mesenchymal stem cells into degeneratively affected IVDs with characteristic pain syndrome in provocative discography, after a year, none of the patients showed a decrease in the intensity of back pain [22]. At the same time, some researchers have found beneficial effects in reducing pain and improving disc morphology [23; 24]. Four to six years after such procedures, their safety is reported; however, disc changes were not of a unidirectional, favorable nature, as they combined both positive and negative signs of the progression of the degenerative process [25].