经皮穿刺腰椎间盘激光汽化减压术的临床应用

目的：探讨经皮穿刺腰椎间盘激光汽化减压术的临床应用和适应证。方法：采用脊柱后外侧人路，在C形臂X线机引导下，将穿刺针定位于椎间隙中心稍偏后部，插入光导纤维，通过激光脉冲汽化部分髓核组织，降低椎间盘内压力，解除突出物对神经根和硬膜的压迫。结果：本组共治疗116例；131个间隙。参照MacNab疗效评价，优90例，占77．6％；良15例，占12．9％；差9例，其中3例行二次激光汽化治疗，5例改为开放手术。结论：本方法是一种有限治疗，但创伤小，安全有效，对脊柱稳定性没有影响。适用于单纯的包容性腰椎间盘突出症患者。

Clinical Application of Laser Gasification Decompression through Percutaneous Lumbar Intervertebral Discs Puncture

Objective: To discuss the clinical application and indication of laser gasification decompression through percutaneous lumbar intervertebral discs puncture.Method:Through the vertebral posterolateral approach and guided by the X-ray apparatus with C-shaped arm,the puncture needle was located at the center of the intervertebral space,then the optical fiber was inserted;by gasifing part of the nucleus pulposus,the pressure of the interverbral disc was reduced,and the compression of the nerve root and annulus fibrosis the protrusion was relieved.Result:One hundred and sixteen patients with 131 intervertebral space were treated.According to MacNab therapeutic evaluation,90 cases were excellent,15 cases were good and 9 cases were poor.Three cases of them were treated twice and 6 cases were treated with open operation.Conclusion:This method is a limited treatment,and it is safe and effective,and the trauma is small.It has no influence to the stability of the vertebrae.It is suitable for the patients with lumbar disc protrusion of a simple containing type.