经皮激光椎间盘减压术（PLDD）联合神经根阻滞治疗腰椎间盘突出症的临床研究

目的探讨经皮激光椎间盘减压术（PLDD）联合神经根阻滞治疗腰椎间盘突出症的机制和临床疗效。方法2004年2月至2007年7月采用PLDD联合神经根阻滞治疗腰椎闾盘突出症病人84例。单间盘突出50例，≥2个间盘突出34例。L3/4节段突出19个，L4/5节段65个，L5/S1节段32个，共116个椎间盘。术后定期随访。结果术前JOA评分平均为（18±6），术后3个月随访JOA评分平均为（26±3），有显著性差异（P〈0．05）。84例病人中62例为优，19例为良，3例为可，优良率为96．4％。术前VAS评分平均为（7．8±1．4），术后一周VAS评分平均为（2．6±1．7），术后3个月VAS评分为（2．1±1．2）有显著性差异（P〈0．05）。结论PLDD联合神经根阻滞治疗腰椎间盘突出症临床疗效满意，可成为一种优化的微创手术推广。

Clinical study on the treatment of lumbar intervertebral disc herniation with percutaneous laser disk decompression (PLDD)and nerve root block

Objective To study of the clinical treatment of lumbar intervertebral disc herniation with percutaneous laser disk decompression （PLDD） and nerve root block. Methods The 84 patients with lumbar intervertebral disc herniation underwent the operation of percutaneous laser disk decompression （PLDD） and nerve root block from Ferb 2004 - Jul 2007 . 50 cases had one disc herniation, 34 cases had two and more than two disc herniation. 19 cases had L 3/4 disc herniation, 65 cases had L1/5 disc herniation, 32 cases had L5/S1 disc herniation, totally 116 discs. All the patients were followed up . Results The score of JOA was（ 18±6）pre-operation , three months after the operation, JOA score was （26±3）, the difference was significant （ P 〈 0. 05）. The clinical results in 84 patients of 62 were excellent , 19 good, 3 fair, excellent and good rate was 96.4%. The score of VAS average was（7.8±1.4） pre-operation,one week after the operation VAS average score was（2.6±1.7）, three months after the operation VAS score was（2.1±1.2）, the difference was significant （P〈0.05）. Conclusions The clinical result of percutaneous laser disk decompression （PLDD） and nerve root block to treat lumbar intervertebral disc herniation is satisfactory , this technique could be widely applied as an optimized minimally invasive surgery.