经皮激光盘内气化减压联合三氧消融术治疗颈椎间盘突出症

PERCUTANEOUS LASER DISC DECOMPRESSION AND OZONE DISSOLUTION IN TREATING HERNIATION OF CERVICAL DISC

目的探讨经皮激光椎间盘气化减压联合三氧消融术治疗颈椎间盘突出症的疗效。方法研究组应用半导体激光（功率0.5-30 W,波长980 nm）、医用臭氧发生器,在X线引导下,选择C2-C7间隙,前路穿刺进入椎间隙中心处,导入600μm光导纤维,以自动脉冲式激光烧灼髓核（300-500 J/每间隙）,然后注入浓度为50μg/mL的O2-O3混合气体5-10 mL,共治疗146例,182个椎间盘。对照组单纯应用激光气化减压术治疗146例,185个椎间盘。结果两组病人均随访3-12个月,资料分析显示研究组疗效优良率（74.65%）和总有效率（93.15%）均显著优于对照组（54.12%,82.19%）（P〈0.01）。结论经皮激光椎间盘气化减压联合三氧消融术治疗颈椎间盘突出症具有创伤小,痛苦少,安全性高,疗效优于单纯应用激光治疗,是微创治疗颈椎间盘突出症的有效组合方法之一。

Objective To explore the clinical effects of percutaneous laser disc decompression and ozone dissoltuion in treating herniation of cervical disc.Methods In the treatment group,the 0.5～3w semiconductor laser of 980nm of length and medical ozone generator were applied.And under the X-ray guide,the C2-C7 interspaces were punctured.600 um light guide fibre was induced to cauterize marrow core with automatic pulse laser（300～500J per interspace）.Then,5～10mL of 50μg/mL O2～O3 mixture was infused.146 cases（182 discs） were treated in this way.The contrast group（185 discs in 146 cases） was treated by simple laser gasification decompression.The follow-up surveys lasted 3～12 months.Results The rates of good effects in the treatment group and the contrast group were 74.65% and 54.12% respectively（P〈0.01）.The total effective rates of the two groups were 93.15% and 82.19% respectively（P〈0.01）.Conclusion The combined use of percutaneous laser disc decompression and ozone dissolution can be effectively used to treat herniation of cervical disc for its little trauma,high security and good clinical effects.