经皮钬激光治疗腰椎间盘突出症

Percutaneous Versa Pulse Holmium Laser Lumbar Discectomy

目的：报告经皮钬激光治疗腰椎间盘突出症的临床效果。方法：自１９９４年６月～１９９５年６月，应用美国科以人公司生产的钬激光机经皮治疗腰椎间盘突出症２６例。其中男１９例，女７例，平均年龄３８岁。Ｌ４－５突出１５例，Ｌ５Ｓ１突出１１例。手术时局麻，后正中线旁８～１０ｃｍ处进针，进针方向与躯干矢状面成４５°角，透视下确认位置。钬激光汽化烧灼髓核组织，有效地降低了椎间盘内的压力，使突出的椎间盘组织回缩，解除了对神经根的压迫。结果：经１～２年随访，优良率８８％。结论：钬激光波长２．１μｍ，作用深度仅０．０４ｃｍ，采用脉冲式发射，具有极高的准确性和安全性。作者认为这是一种安全、有效的方法。

Between June 1994 and June 1995, 26 percutaneous lumbar discectomies were performed with Versa Pulse Holminm Laser Operator (Coherent Medical Group). There were 19 males and 7 females. The average age was 38 years. Fifteen patients sustained L 4- 5 lesion and 11 L 5S 1 lesions. Under local anesthesia, the instruments were inserted at a 45 degrees angle sagital to the trunk, and the entry point was located 8 to 10 cm from the midline. A fluoroscope was used to ensure proper instrument placement. The disc tissue was vaporized by laser, so that the intradiscal pressure was declined and the nerve root compression was relieved. With an average of 1 to 2 years follow_up, 88% of the patients rated excellent and good results. The wave length of versa pulse holminm laser is 2.1μ m, and the penetration depth is 0.04cm, which ensure the laser instantaneously vaporizes the target tissue with minimal themal damage to the adjacent structures. The authors considered this technique is a safe and effective method for lumbar disc herniation.