The current study evaluated the efficacy of LADD within the Medicare population, and examined the influence of coexisting medical conditions and previous surgical intervention on surgical outcome. Patients who met inclusion criteria underwent laser-assisted disc decompression (LADD) using the Holmium: YAG Laser with Sidefire laser fiber. All patients evidenced primarily leg pain, with or without back pain, which had failed a minimum of six weeks conservative treatment. Post-operative follow-up at one year yielded a surgical success rate of 80%. Surgical outcome was not related to coexisting medical conditions or previous surgical intervention on the lumbar spine. Findings of the current study suggest that LADD offers a viable alternative treatment modality for lumbar disc disease within the Medicare population.