激光颈椎间盘汽化减压术安全性的实验研究

Safety of cervical disc-decompression with the semiconducting laser:an experimental study

目的 :初步探讨激光椎间盘减压术在颈椎间盘外科中应用的安全性。方法 :采用 7具新鲜人颈椎标本 ,使用 4组不同能量半导体激光对颈椎间盘进行汽化 ,测量汽化后汽化腔的面积、组织学变化及椎间盘周围部位温度变化。采用 12具新鲜羊颈椎标本 ,使用 4组不同能量激光汽化减压后 ,放置CTM 140 4试验机上进行压缩、拉伸刚度测定。结果 :椎间盘汽化后体积随能量的增加而加大 ,汽化腔局限于髓核内 ,周边纤维环及软骨终板未见明显破坏 ,椎间盘周围结构的温度变化不大 (<2℃ ) ,压缩、拉伸刚度减少。结论 :半导体激光颈椎间盘汽化减压术具有一定安全性 。

Objective:To preliminarily investigate the safety of semiconducting laser on cervical intervertebral disc in cervical surgury.Methods:The discs of 7 fresh human and 12 fresh goat cadaveric spines(C2～T1) were radiated with the semiconducting laser varying from 400 J to 1000 J energies in 4 groups. The ablated surface area,changes in temperature at three important sites around the disc were measured and its histological effects were observed in human spine specimens. Stiffness of elongation and compression were measured in goat spine specimens.Results:The ablated surface area was significantly greater at higher radiating energies. The increase in temperature of adjacent tissue was very low(not exceeding 2 ℃). There was a significant decrease in stiffness of elongation and compress after ablation of nucleus pulposus tissue. No evidence was found to show anular fibers and cartilaginous end plates were damaged.Conclusion:The use of semiconducting laser in cervical discectomy is safe. But the stiffness of elongation and compression after ablation significantly decreases.