经皮激光椎间盘减压术治疗腰椎间盘突出症

目的探讨C臂X线监测下Nd:YAG激光经皮腰椎间盘减压术(PLDD)的临床疗效。方法选择合适的病例在X线透视下从病变侧棘突旁开8~10cm,与矢状面呈35°~45°角,将18G穿刺针穿入病变椎间盘内,行盘内多点、低能量激光照射(每点能量400~600J,总能量1600~2000J)。术中多次抽吸及清理光纤以免影响疗效。结果本组32例,共40个椎间盘。术后1个月疗效为优80%(25/32),良6%(2/32)、可9%(3/32)、差6%(2/32)。结论C臂X光引导下经皮激光介入椎间盘减压术有微创、痛苦小、恢复快、效果稳定的特点,近期及中期临床效果较理想,并发症极少。

Percutaneous laser disc decompression in lumbar intervertebral disc protrusion

Objective To discuss the effect of percutaneous laser disc decompression(PLDD) therapy by adopting the Nd:YAG Laser under C-arm X-ray monitoring.Methods A total of 32 cases were included in this study. There were 15 males and 17 females, the age ranged from 22 to 65 years, with the average of 34.8 years, and the course of disease from 1 month to 13 years. Two cases of lumbar intervertebral disc prolapse were diagnosed between L3 and L4, 16 cases between L4 and L5, 6 cases between L5 and S1, 8 cases with two disc prolapse at the same time. A total of 40 intervertebral-disc operations were conducted with PLDD. All the cases selected had been examined by MRI, and their clinical symptoms and physical signs were in compliance with the diagnosis standards for prolapse of lumbar intervertebral disc.Results After PLDD operation, 25 cases were cured within 1 month with a cure rate of 80%.Conclusion C-arm X-ray guided PLDD therapy is an ideal non-operative therapy for lumbar intervertebral disc prolapse with the advantages of micro-trauma, less pain, quick recovery and good effect. PLDD has achieved encouraging effects in its recent outcome and medium-term effect as well.