经皮激光椎间盘减压术结合牵引治疗腰椎间盘突出症疗效观察

【目的】探讨经皮激光椎间盘减压术(PLDD)结合牵引治疗腰椎间盘突出症的临床疗效。【方法】运用经皮激光椎间盘减压术治疗腰椎间盘突出症患者40例,术后予以腰椎土法牵引治疗7 d。治疗后随访4个月,按照日本腰背痛手术评分(JOA评分)和视觉模拟评分(VAS评分)进行疗效评定。【结果】(1)4个月后,接受随访的40例患者中,优18例,良18例,中2例,差2例,优良率为90.0%。对应于通常采用的疗效判定标准:治愈10例,显效26例,有效2例,无效2例,总有效率为95.0%。(2)手术前后VAS评分分别为(7.7±1.0)分和(1.0±1.8)分,手术前后比较,差异有统计学意义(P<0.01),显示术后较术前VAS评分明显下降,患者术后疼痛程度较术前明显减轻。(3)除有2例患者出现一过性腰痛外,其他无1例出现神经脊髓损伤、感染等并发症。【结论】经皮激光椎间盘减压术结合牵引治疗腰椎间盘突出症疗效确切,能较明显地减轻患者的痛楚,具有简便、易行、价廉、效果确切、副作用小、安全系数大的优点。

Therapeutic Effect of Percutaneous Laser Disc Decompression Combined with Traction for Lumbar Intervertebral Disc Protrusion

Objective To explore the therapeutic effect of percutaneous laser disc decompression combined with traction for lumbar intervertebral disc protrusion.Methods Forty patients with lumbar intervertebral disc protrusion received percutaneous laser disc decompression,and then were given traction for 7 days.The follow-up covered 4 months,and the scores of surgery issued by the Japanese Orthopedic Association(JOA) as well as the scores of visual analog scale(VAS) were examined to evaluate the therapeutic effect.Results The follow-up results showed that the effect was excellent in 18 patients,good in 18,average in 2 and poor in 2,and the excellent and good rate was 90.0%.The therapeutic effect evaluated by conventional criteria showed that 10 patients were cured,26 markedly effective,2 effective and 2 ineffective,and the total effective rate was 95.0%.The VAS score was 7.7±1.0 before treatment and 1.0±1.8 after treatment,and the difference was significant(P<0.01),indicating that the pain was relieved after treatment.Transient lumbago occurred in 2 patients,and no spinal cord injury or infection was found in any patient.Conclusion Percutaneous laser disc decompression combined with traction exerts certain effect for lumbar intervertebral disc protrusion through relieving pain.The therapy is effective and safe,simple,practical and economic,with a good perspective for clinical use.