Intraoperative clinical use of LLLT following surgical treatment of the tethered spinal cord

Based on our previous experimental investigation¹ [formula omitted] which indicated that low-level laser irradiation has a significant therapeutic effect and treatment potential on the injured nerve tissue, we began using this method in clinical practice. This study represents our first clinical results in the treatment of four patients with tethered spinal cord resulting from fibrous adhesions at the site of previous myelomeningocele and lypomyelomeningocele repair, thickened filurn terminale and spinal lipoma. After surgical release of the tethered spinal cord, stable evoked responses were recorded and the conus medullaris was subjected to direct laser irradiation (CW He-Ne laser, 632.8 nm. 7 J/em²). We found that intraoperative laser treatment increases evoked responses from 15–52% (mean 26.7%). In a previous work, we showed that direct laser irradiation promotes restoration of the electrophysiological activity of the severely injured peripheral nerve, prevents degenerative changes in neurons of the spinal cord and induces proliferation of astrocytes and oligodendrocytes.[formula omitted] This suggested a higher metabolism in neurons and improved ability for myelin production under the influence of laser treatment. The tethering of the spinal cord causes mechanical damage to neuronal cell membranes leading to metabolic disturbances in the neurons. For this reason, we believe that using low-level laser therapy (LLLT) may improve neuronal metabolism, prevent neuronal degeneration and promote improved spinal cord function and repair.