经皮激光椎间盘减压术联合臭氧髓核氧化术治疗颈椎间盘突出症的效果观察

Percutaneous laser disc decompression combined with ozone nucleus gelatinosus oxidizing technique for cervical intervertebral disc protrusion

目的 探讨经皮激光椎间盘减压术（percutaneous laser disc decompression,PLDD）加臭氧（O3）髓核氧化术联合治疗颈椎间盘突出症的疗效.方法 应用医用半导体激光和医用O3发生器,在X线引导下采用18G穿刺针经皮穿刺至髓核区,然后由穿刺针插入600μm光导纤维,用脉冲式激光切割、汽化髓核,以每个椎间盘500～600 J切割、汽化,再向椎间盘注入浓度为60μg/ml O3约3～5 ml.结果 共治疗197例289节椎间盘,197例患者术后随访3～36月,参照日本骨科协会（JOA）颈椎病治疗疗效判定结果计算改善率,≥75%135例,50%～74%57例,25%～49%5例,＜25% 0例,优良率97.5%.结论 经皮激光椎间盘减压术加臭氧髓核氧化术组合治疗颈椎间盘突出症,适应症广,操作简便,创伤小,安全性高,恢复快,疗效佳,值得临床推广.

Objective To explore the efficacy of percutaneous laser disc decompression （PLDD） combined with ozone nucleus gelatinosus oxidizing technique for cervical intervertehral disc protrusion （CIDP）. Methods A spinal needle was inserted in the space of nucleus gelatinosus under X-ray guidance. 197 patients with 289 intervertebral discs received impulse laser excision and vaporizing （with the power of 500- 600 J for each intervertebral disk） and infections of O3 of 3 to 5 ml at a concentration of 60 μ g/ml. Results Of 197 patients with a follow-up of 3 to 36 months, 135 had an excellent efficacy, 57 had a good efficacy, and 5 had some efficacy. The total ideal effective rate was 97.5%. Conclusions Percutaneous laser disc decom- pression combined with ozone nucleus gelatinosus oxidizing technique for cervical intervertebral disc protru- sion is simple, safe, effective, easy to operate, and minimally aggressive.