经皮激光椎间盘减压术后影像学变化的中期随访

目的 观察经皮激光椎间盘减压术(PLDD)后中期随访影像学变化,评价该手术的安全性和有效性.方法 回顾性分析经PLDD治疗的22例颈腰椎病患者的临床资料,其中男性10例,女性12例;年龄44～73岁,平均58岁;随访时间36～54个月,平均41.5个月.椎间盘分布:颈椎12例27个,腰椎10例22个;其中C_(3～4)3个,C_(4～5)8个,C_(5～6)10个,C_(6～7)个,L_(2～3)2个,L_(3～4)2个,L_(4～5)9个,L_5S_1 9个.在侧位x线片应用手术椎间隙高度与椎体高度比值观察手术前后病变椎间隙高度变化;在MRI横断面上,应用椎间盘突出指数观察手术间盘突出情况的变化,并对结果进行统计学分析.结果 术后末次随访病变椎间盘椎间隙前缘高度、中心高度及后缘高度较术前无明显变化(P>0.05).颈椎间盘病变节段突出指数术前为0.10～0.54,术后末次随访为0.06～0.39,差异有统计学意义(P<0.05);腰椎间盘病变节段突出指数术前为0～0.71,末次随访为0～0.48,差异有统计学意义(P<0.01).结论 PLDD术后对椎间隙高度没有明显影响,该手术能有效促进椎间盘突出物的缩小.从影像学上分析,PLDD是治疗颈腰椎病的一种安全有效的微创手术.

Analysis of middle-term outcome of the imaging characteristics after the percutaneous laser disc decompression

Objective To study the imaging findings outcome of the percutaneous laser disc decompression (PLDD) and evaluate the middle-term safety and efficacy of PLDD. Methods The imaging datas of 22 eases suffered cervical spondylosis or lumbar spondylosis and treated by PLDD more than 3 years were retrospectively reviewed. To observe the intervertebral space of the iuvasive disc and the intervertebral disc hernia before and after the operation on the lateral projection of X-ray and the axial view of the MRI. To make a statistical analysis of the dates. Results There was no obvious change of disc height involving the anterior disc height, the intermediate disc height and the posterior disc height after the PLDD at the final follow-up(P>0. 05). At last time follow-up, the Sagittal Index(SI) are 0. 10-0. 54 and 0. 06-0. 39 before and after the PLDD in the treatment of cervical vertebra. The statistical difference were significant (P<0.05). In lumbar vertebra, the SI is 0-0.71 and 0-0.48 disc before and after the PLDD. The statistical difference were very significant (P< 0. 01 ). Conclusions The PLDD will not destroy the intervertebral space of the cervical and lumbar vertebra obviously; moreover, it can effectively reduce the diskal hernia. The PLDD is a safe and effective Mini-invest surgery for cervical vertebra and lumbar vertebra diseases.