经皮激光汽化减压术联合硬膜外神经阻滞治疗腰椎间盘突出症

目的观察经皮激光椎间盘汽化减压术联合硬膜外神经阻滞治疗腰椎间盘突出症的临床疗效。方法选择102例腰椎问盘突出症患者在CT引导下行经皮激光椎间盘汽化减压术,针尖进入椎间盘,输出功率8W,脉冲持续和间隔时间均为1.0 s,照射总量600～2200 J,术毕联合腰椎硬膜外神经阻滞,注入利多卡因、得宝松与维生素B_(12)复合液。结果102例患者治疗后10日与6个月进行疼痛评价,94例症状、体征消失或明显好转,其中优分别为76例与89例,占74.5%与87.2%,良分别为18例与5例,占17.6%与4.9%,优良率为92.2%与92.2%。结论经皮激光椎间盘汽化减压术是目前治疗椎间盘突出症较为有效的方法之一,联合硬膜外神经阻滞治疗,可取得更满意的疗效。

Vaporization and decompression by percutaneous laser and combined with epidural block for treatment of lumbar intervertebral disc herniation

Objective To observe the efficacy of vaporization and decompression by percutaneous laser and combined with epidural block for treatment of lumbar intervertebral disc herniation.Methods One hundred and two patients suffered from lumbar intervertebral disc herniation were included.Guided by CT the needle point was inserted into lumbar intervertebral disc,then vaporization and decompression were operated with laser,output power 8 W,pulse time 1 second,interval time 1 second and total laser energy 600-2 200 J.After that lidocaine,diprospan and vitamine B_(12) were injected into epidural space.Results Ten days and six months later the treatment efficacy was evaluated for all cases with excellent 74.5%(76 cases)and 87.2%(89 cases),good 17.6%(18 cases)and 4.9%(5 cases)respectively.The rates of excellent and good were all 92.2%.Conclusion Vaporization and decompression by laser for treatment of lumbar intervertebral disc herniation is an effective method and it combined with epidural block has more satisfactory effects.