PVMA Keystone Veterinarian Spring 2021 - 16

Percutaneous Laser
Disc Ablation (PLDA):

A Minimally Invasive Way
to Prevent IVDD in Dogs
By Gaemia Tracy, DVM
Practice Limited to Neurology
(VRC in Malvern, PA)

What Is
Intervertebral Disc
Disease (IVDD)?
Intervertebral Disc
Disease (IVDD) is a condition
in which the discs between
the vertebrae degenerate. The
disease may cause any degree
of neurologic dysfunction, from
weakness and difficulty walking
to permanent paralysis. IVDD
affects approximately 25%
of chondrodystrophic breeds (i.e.,
Dachshund, Beagle, Chihuahua, Maltese,
Shih-Tzu, French Bulldog, Bassett Hounds,
Corgi, Pekingese, and Lhasa Apso).
Intervertebral discs are composed of
a central, gel-like nucleus pulposus
surrounded by a cartilaginous ring
called the annulus fibrosis. IVDD is
more prevalent in chondrodystrophic
breeds because the nucleus pulposus of
these breeds can begin to degenerate
between 1 and 2 years of age. The
nucleus pulposus becomes calcified and
puts excessive pressure on the annulus
fibrosus, causing the annulus fibrosus to
weaken over time. It develops a bulge
that compresses the spinal cord, and any
rupture in the annulus fibrosus allows the
nucleus pulposus to escape. This results
in compression of the spinal cord within
the vertebral canal, which leads to pain
and neurologic dysfunction.
16 | Keystone Veterinarian

Can IVDD Be Prevented?
While surgery can be performed to
address this condition once it occurs,
there is a procedure called Percutaneous
Laser Disc Ablation (PDLA) that can
prevent the disc herniations that cause
IVDD in chondrodystrophic breeds, thus
avoiding the need for emergency surgery.
The procedure can be performed in
any at-risk, chondrodysplastic dog but
is especially recommended for those
patients who have had clinical signs of
IVDD in the thoracolumbar spine. All disc
spaces from T10-11 through L4-5 (the
most common sites of herniation) receive
treatment during the procedure.
PLDA is a fluoroscopically-guided
procedure that prevents disc herniation
in a minimally invasive manner. PLDA
uses light from a Holmium yttrium

aluminum garnet (Ho:YAG)
laser, delivered through spinal
needles inserted through the
skin and into thoracolumbar disc
spaces, to slow down the rate
of mineralization of the nucleus
pulposus, thus decreasing the
likelihood of a disc herniation.
The Ho:YAG laser's wavelength
(2100 nm) is strongly absorbed
by water while offering a
reduced depth of penetration,
which increases the likelihood
that it will be absorbed by the
nucleus pulposus, while decreasing the
risk of collateral thermal damage to
the annulus fibrosus and surrounding
structures. This revolutionary procedure
is only offered at three hospitals in the
United States:
* Oklahoma State University
(Stillwater, OK)
* Dallas Veterinary Surgical Center
(Dallas, TX)
* Veterinary Referral Center [VRC]
(Malvern, PA)

PLDA in Action: A Case Study
The most recent patient to receive
PLDA at VRC was a French Bulldog
named Nugget McConkey. Nugget is a
lovable 4-year-old spayed female that
is owned by a veterinarian. Nugget had
PVMA Keystone Veterinarian Spring 2021

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