等离子刀颈椎间盘髓核成形术效能及安全研究

目的探讨不同能量颈椎间盘等离子刀髓核成形术（CN）效能及安全性。方法对40个C3～T1羊椎间盘按照不同能量分1档（A组,80W）、2档（B组,100W）、3档（C组,120W）3个实验组,每组10个椎间盘;另设假手术组作为对照组（10个间盘,仅作穿刺）。分别通过相同时间（40s）不同能量组行羊颈椎间盘CN,观察CN在椎间盘所形成的消融腔截面积大小,记录椎间盘前缘、后缘、椎间孔处温度变化并对其进行统计学分析。结果A、B、C组手术消融腔、对照组穿刺腔截面积分别为（3.000±0.449）mm^2、（9.436±1.271）mm^2、（27.359±2.001）mm^2、（2.010±0.000）mm^2,其中B、C档组与对照组比较差异有显著性（P〈0.05）。A、B、C3个实验组、对照组温度分别为：（28.697±1.571）℃、（35.470±0.617）℃、（41.733±0.345）℃、（20.600±0.582）℃,3个实验组温度与对照组比较差异有显著性（P〈0.05）。3种能量手术时,2档温度在安全范围内,3档形成的有效消融腔截面积最大,消融腔、温度与能量成正相关。结论等离子刀髓核成形术的效能、温度变化与能量成正相关，临床使用2档行颈椎间盘CN消融效能和安全性最高。

Coblation nucleoplasty in cervical intervertebral disc:effect and safety research

Objective To study the effect and safety of different energy magnitude coblation nucleoplasty in cervical intervertebral disc.Methods 40 sheep intervertebral discs C3～T1 were randomized into 3 groups according to different magnitude energy used in the manipulations（10 cervical intervertebral discs in each group）：Group A（80 W）,Group B（100 W）,and Group C（120 W）.The control group was also set（10 discs only performed the puncture）.The coblation time was 40 s in all cases.The anterior and posterior disc heights,coablation cavity areas,and temperature were compared.Results The ablation cavity areas were（3.000±0.449）mm^2,（9.436±1.271）mm^2,（27.359±2.001）mm^2 in Group A,B and C,respectively.The control group＇s puncture of the form cavity cross-sectional area was（2.010±0.000）mm^2.The differences were significant compared to the control（P0.05）;Three experimental group temperatures for（28.697±1.571）℃,（35.470±0.617）℃,（41.733±0.345）℃ and the control group temperatures for（20.600±0.582）℃.The difference was significant（P〈0.05）;In the three kind of energy surgeries,Group B is more safe in terms of temperatures in the margin.The effective ablation cavity cross-sectional area in Group C was biggest,the ablation cavity,the temperature and the energy become were positively related.Conclusions The coblation nucleoplasty of temperature change and the energy become are positively related.It is effective and safe to performed coblation nucleoplasty with 100 W energy.