经皮激光汽化减压术对造影结果不同的腰椎间盘突出症的疗效对比

Comparison of the clinical effect of percutaneous laser disc decompression in the treatment of lumbar disc herniation with different results of discography

目的对比经皮激光汽化减压术（PercutaneousLaserDiscDecompression，PLDD）对两种椎间盘造影结果的腰椎间盘突出症的疗效，结合文献探讨椎间盘造影及PLDD的临床应用。方法自2010-01—2013-05行PLDD治疗的单节段腰椎间盘突出症患者58例进行回顾性分析，术前造影阴性的16例为A组，阳性者42例为B组；激光烧灼总能量控制在300～600J，汽化减压并反复抽吸；对2组患者术前、术后即刻和随访时的临床表现、直腿抬高角度及JOA评分进行比较。结果A组与B组在术前、术后即刻和随访时直腿抬高角度及JOA评分均无显著差别。结论椎间盘造影阴性并不能完全排除椎间盘源性腰腿痛；椎间盘造影结果不同的两组腰椎间盘突出症患者在PLDD的中期疗效上无显著差异。

Objective To compare the effect of percutaneous laser disc decompression （PLDD） in the treatment of lumbar disc herniation with different results of discography,and to explore the clinical application of discography and PLDD. Methods The clinical data of,58 cases with single segmental lumbar disc herniation treated by PLDD from January 2010 to May 2013 were retrospec- tively analyzed. 16 cases with negative discography were selected as group A,and 42 cases with positive discography were selected as group B. Inserted the laser fiber cauterization and total ener- gy control in 300-600J,vaporization and repeated aspiration. The clinical manifestations,straight leg raising angle and the JOA low back pain score at preoperation,immediate postoperation and follow- up time were compared. Results No significant differences of straight leg raising angles and JOA scores were found between group A and B at preoperation,immediate postoperation and the last follow-up time. Conclusion The negative discography does not completely rule out of the disco- genie low back pain, and no significant difference of mid-term clinical effect of PLDD is found be- tween the two groups with different discography results.