经皮激光低温治疗椎间盘源性腰痛的实验研究

Experimental Study on Percutanous Laser Hypothermia for Treating Discogenic Low Back Pain

【目的】初步探讨低功率激光低温治疗椎间盘源性腰痛的临床可行性,并初步获取激光应用最佳功率。【方法】采用2具新鲜猪脊椎标本,选取32个椎间盘,随机分成4组,每组8个椎间盘,进行激光实验,调节激光功率,测试2.5w、3.0w、3.5w、4w四种不同功率下,固定采用间断脉冲激光,间隔时间1.0s,脉冲时间1.0s,持续时间为1h,分别在10min、20min、30min、60min4个时间点测试椎间盘髓核中央、内层纤维环温度变化。【结果】激光功率4w时,持续时间大于10min以后椎间盘髓核温度迅速超过100℃,内壁温度上升也快,温度不容易控制;在激光功率3～3.5w时可在20～30min内使髓核和内壁温度达到理想温度,温度容易控制,而2.5w功率时60min时也不能使椎间盘内壁温度达到55℃。在相同功率条件下,椎间盘内温度在30～60min时间段无大幅度的提高。【结论】低功率激光可以通过对激光脉冲持续时间的调节而使椎间盘内温度达到治疗椎间盘源性腰痛所需温度的理想状态。

[Objective]to evaluate the clinical feasibility of low-power laser hypothermia for treating discogenic low back pain, and to get the best laser-power for clinic work. [Methods]Thirty-two discs were obtained from two fresh pig spine specimens. The specimens were divided into four groups with 8 discs in each group. The discs were radiated with the semiconductor laser varying from 2.5 to 4.0w power in 4 groups. The changes in temperature at two important sites around the disc at 10, 20, 30 and 60 minutes were measured. CResults] At 10 minutes, the temperature at disc center with the semiconducting laser 4.0w power was not easy to be controlled, and the temperature in the internal wall of discs rised quickly over 10 minutes, and the discs started to ablate. With the semiconductor laser 3-3.5w power, the temperature in the internal wall of discs could get to theoretical optimum condition. But with the semiconductor laser 2.5w power, the temperature in internal wall of discs could not get to 55℃. Otherwise, the temperature with the same power was not raised at 30-60 minutes. [Conclusion]Low-power laser can be adjusted to advisable temperature, and this experimental result can provide the theoretical condition for treating low back pain.