经皮激光椎间盘汽化减压术联合臭氧消融术治疗腰椎间盘突出症

目的评价经皮激光椎间盘汽化术（PLDD）加臭氧（O3）消融术术联合治疗腰椎间盘突出症的疗效。方法在C形臂X光机引导下采用18G穿刺针经皮穿刺至髓核区，由穿刺针插入400μm光导纤维，用单个脉冲激光汽化髓核，以每个椎间盘总能量1500～1800J切割、汽化，再向椎间盘内注入浓度为50mg·ml^-1 O3约5～8ml，共治疗36例49节椎间盘。结果本组技术成功率为100％，术中无严重并发症发生：随访3～12个月后，36例中，21例疗效为优，12例为良，2例为有效，1例为差，优良率91．6％。结论经皮激光椎间盘汽化术加臭氧消融术组合治疗治疗腰椎间盘突出症疗效佳，创伤、痛苦少且安全，值得临床推广。

Percutaneous laser disc decompression combining ozone ablation treatment treats lumbar disc herniations

Aim To explore the therapeutic effects of percutaneous laser disc decompression(PLDD)combining with ozone ablation treatment technique to treat lumbar disc herniations(LDH).Methods Under C-arm X-ray guidance,the spinal needle(18G) was inserted to the space of the nucleus gelatinosus.All 36 patients with 49 intervertebral discs were treated by single pulsed wave mode laser cutting and vaporizing(with the power of 1500~1800 J for each lumbar intervertebral disc)and then O3(5~8 ml with concentration of 50 mg·ml-1) was injected.Therapeutic effects were judged by Macnab’standard.Results Among the total 36 patients with the follow up of 3 to 12 months,21 patients had excellent therapeutic effects,12 patients good therapeutic effects,2 patients some therapeutic effects and 1 patient no therapeutic effects.The total excellent and good effective rate was 91.6 %.No severe complcations occurred among the patients.Conclusion PLDD combining with ozone ablation treatment is a safe and effective method for the treatment of LDH.