PLDD治疗拒绝开放手术的脊髓型颈椎病患者的疗效观察与思考

The effects and thinking of percutaneous laser disc decompression for cervical spondylotic myelopathy unavailable to open operation

目的:探讨经皮激光椎间盘减压术(PLDD)治疗拒绝开放手术的脊髓型颈椎病患者的疗效。方法:2002年～2006年应用PLDD治疗16例拒绝开放手术的脊髓型颈椎病患者,手术前后采用日本骨科学会(JOA)17分法进行评价,计算改善率及优良率,随访观察治疗效果。结果:手术时间平均为15min,术中无明显出血,无血管、神经损伤及感染等并发症发生。术后1、3、6、12个月时JOA评分改善率分别为28.54%、34.82%、41.09%和47.57%,优良率分别为31.3%、37.5%、37.5%和56.0%。随访24个月者11例,改善率为46.56%,优良率为54.4%。结论:PLDD治疗脊髓型颈椎病患者有一定疗效,对拒绝开放手术的脊髓型颈椎病患者是一种可供选择的微创治疗手段。

Objective：To evaluate the clinical outcomes of percutaneous laser disc decompression（PLDD） for cervical spondylotic myelopathy（CSM） unavailable to open operation.Method：Between 2002 to 2006,a total of 16 cases with CSM while unavailable to open operation underwent the PLDD,the clinical outcome before and after surgery was evaluated by JOA scoring system,and the improvement rate was reviewed retrospectively. Result：The mean operate duration was 15 minutes,no neurovascular injury or infection was noted.The improvement rate at lst,3st,6st,12st month was 28.54% ,34.82% ,41.09% ,47.57% respectively,and the excellent and good rate was 31.3%,37.5%,37.5% and 56.0% respectively.ll cases were followed up at least 24 months with the mean improvement rate and excellent rate of 46.56% and 54.4% respectively.Conclusion： PLDD can deal with CSM to some degree,which is a micro-invasive alternative for CSM unavailable to open operation.