X线导向Nd:YAG激光器行介入椎间盘减压术治疗腰椎间盘突出症

Treatment of lumbar intervertebral disc prolapse with X-ray guided Nd: YAG Laser interposing percutaneous laser disc decompression

目的探讨在X线电视监控下采用日本产Nd:YAG Laser CL-50激光器行经皮激光腰椎间盘减压(PLDD)术.方法分析378例术后病例,病程1个月至16年.L2～3椎间盘突出17例,L3～4椎间盘突出35例,L4～5椎间盘突出140例,L5～S1椎间盘突出116例,2个椎间盘同时突出60例,3个椎间盘同时突出10例,共施行PLDD术458个椎间盘.所选病例均经CT或MR检查及临床症状、体征符合腰椎间盘突出症的诊断标准.结果行PLDD术后1个月治愈268例,治愈率70.90%;3个月治愈259例,治愈率68.52%;6个月治愈260例,治愈率68.25%,治疗效果满意率、有效率及失败率是稳定的.结论 X线导向下行经皮激光介入椎间盘减压术有微创、患者痛苦小、恢复快、效果较稳定的特点,治疗的近期临床效果较佳,远期临床效果也很理想.

Objective To discuss the percutaneous laser disc decompression （PLDD） therapy by adopting the Nd ： YAG Laser CL-50 Device under X-ray monitor supervision. Methods A total of 378 cases were included in this study. There was 198 males and 180 females, the age ranged from 19 to 76 years, with the average of 43.9 years, and the course of diseases from 1 month to 16 years. 17 cases of lumbar intervertebral disc prolapse were diagnosed between L2 and L3, 35 cases between L3 and L4, 140 cases between L4 and LS, and 116 cases between L5 and S1. 60 cases with two intervertebral disc prolapses at the same time, and 10 cases with three intervertebral disc prolapses at the same time. A total of 458 intervertebral-disc operations were conducted with PLDD. All the cases selected had been examined by CT or MRI, and their clinical symptoms and physical signs were in compliance with the diagnosis standards for prolapse of lumbar intervertebral disc. Results After PLDD operation, 268 cases were cured within 1 month with a cure rate of 70. 90% ; 259 cases were cured in 3 months with a cure rate of 68.52% , 260 cases were cured in 6 months with a cure rate of 68. 25% . Stable results were found with curing satisfaction rate, effective rate and failure rate. Conclusion X-ray guided PLDD therapy is an ideal nonoperative therapy for curing lumbar intervertebral disc prolapse with micro-trauma, little pain, quick recovery and good effect. PLDD has achieved encouraging effects both in its recent clinical outcome and long term effect as well.