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经皮激光椎间盘减压术治疗侧旁型颈椎间盘突出症的临床研究

Clinical efficacy of percutaneous laser disc decompression in the tre atment of posterolateral cervical disc herniation

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【作者】 朱杰诚镇万新王巨杨大志王多刘洪涛

【Author】 ZHU Jie-cheng, ZH EN Wan-xin, WANG Ju, YANG Da-zhi, WANG Duo, LIU Hong-tao.Department of Spinal Surgery, The Second Affiliated Hospital of Jinan University, ShenZhen 518020, China

【机构】 暨南大学医学院附属第二医院脊柱外科暨南大学医学院附属第二医院脊柱外科 518020深圳518020深圳

【摘要】 目的 评价经皮激光椎间盘减压术 (percutaneouslaserdiscdecompression ,PLDD)治疗侧旁型颈椎间盘突出症的疗效。方法 自 2 0 0 1年 10月应用PLDD对 2 8例确诊为侧旁型颈椎间盘突出症患者 (共 2 9个颈椎间盘突出 )进行治疗 ,在X线定位下 ,用 9号穿刺导针作颈前穿刺 ,将光导纤维导入病损椎间盘内 ,使用波长为 1.0 6μm的Nd :YAG激光对突出髓核组织进行气化 ,以达到减压效果。结果 术后随访 3~ 17个月 (平均8.2个月 ) ,临床疗效优 18例 (64 .3 % ) ,良 6例 (2 1.4% ) ,可 2例 (7.1% ) ,差 2例 (7.1% ) ,总有效率为 92 .9% ,优良率为 85 .7% ,无并发症发生。结论 PLDD能有效治疗侧旁型颈椎间盘突出症 ,具有临床操作简单、患者创伤小、手术安全性高、并发症少、恢复快等优点

【Abstract】 Objective To investigate the clinical ef fe ct of percutaneous laser disc decompression (PLDD) in the treatment of posterola teral cervical disc herniation. Methods Twenty-eigh t patients with posterolateral cervical disc herniation (totally with 29 intrave rtebral disc herniated) were recruited. PLDD were performed to treat these patie nts.The laser fiber was introduced into the herniated disc tissue through the No .9 needle which puncturing through skin in the front of neck at the opposite sid e of herniated cerivcal disc under fluoroscopy. The decompression and vaporizati on of the disc nuclear were performed with Na:YAG laser with wave-length 1.06μ m and output power 15 W with 1 second emission and 5 seconds interval. The tot al laser energy used in the treatment was 500-950J. Results The follow-up time ranged from 3 to 20 months with a mean of 8.5 mo nths. The evaluation of the therapeutic effect were 18 excellent(64.3%), 6 good (21.4%), 2 fair(7.1%) and 2 poor(7.1%). Total effective ratio was 92.9% and t he ratio of excellent and good was 85.7%. No complications were found. Conclusion PLDD was effective in the treatment of posterolate ral cervical disc herniation. It is very safe, mini-invasive and easy to admini ster, in addition to causing very less complications.

【关键词】 颈椎椎间盘减压激光
【Key words】 Cervical vertebraeIntravertebral di sc decompressionLaser
  • 【文献出处】 中华物理医学与康复杂志 ,Chinese Journal of Physical Medicine and Rehabilitation , 编辑部邮箱 ,2003年09期
  • 【分类号】R687.3
  • 【被引频次】10
  • 【下载频次】62
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