目的:評(píng)價(jià)經(jīng)皮激光椎間盤(pán)減壓術(shù)(Semiconductor Percutaneous Laser Disc Decompression,PLDD)治療椎間盤(pán)源性腰痛的療效。方法:對(duì)我院采用SPLDD治療d的56例進(jìn)行回顧性分析。經(jīng)皮激光椎間盤(pán)減壓術(shù)(PLDD)治療椎間盤(pán)源性腰痛56例(70個(gè)椎間盤(pán)),每只椎間盤(pán)需激光能量如下:L3～4、L5～S1為:1 200～1 400J;L4～5為1300～1500J。比較手術(shù)前后疼痛強(qiáng)度數(shù)字等級(jí) (pain intensity numerical rating scale, PINRS)評(píng)分,進(jìn)行療效觀察和評(píng)定術(shù)后根據(jù)癥狀緩解程度。結(jié)果:隨訪3月為(2.1±0.4)分 (與術(shù)前比較,P lt;0.05);本組56例病例中,PINRS評(píng)分由術(shù)前平均(8.0±0.3)分改善到術(shù)后(2.0±0.2),共39例,占69.6%;(9.0±0.5)分改善到術(shù)后(4.0±0.6)共17例,占30.4%。未見(jiàn)椎間盤(pán)炎及其他并發(fā)癥發(fā)生。手術(shù)時(shí)間15～60m in,平均30 m in。結(jié)論:SPLDD治療椎間盤(pán)源性腰痛安全、有效、微創(chuàng),值得推廣。
引用本文： 余彬,楊志軍,李康仁,鄧寧. 半導(dǎo)體激光減壓術(shù)治療椎間盤(pán)源性腰痛. 華西醫(yī)學(xué), 2009, 24(6): 1393-1395. doi: 復(fù)制
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- 1. CROCK HV. Internal disc disruption. A challenge to disc prolapse fifty years on[J]. Spine, 1986, 11(6): 650-653.
- 2. SCHWARZER AC, APRILL CN, DERBY R, et al. The prevalence and clinica1features of internal disc disruption in patients with chronic low back Pain[J]. Spine, 1995, 20(17): 1878-1883.
- 3. COHEN SP, LARKIN T, FANT GV, et al. Does needle insertion site affect diskography results? A retrospective analysis[J].Spine, 2002, 27(20):2279-2283.
- 4. 羅狄鑫,李貴濤,陳錫然,等.經(jīng)皮穿刺腰椎間盤(pán)半導(dǎo)體激光汽化減壓術(shù)的臨床應(yīng)用[J]. 中醫(yī)正骨,2007,19(9):35-37.
- 5. FARRAR JT, YOUNG JP JR, LAMOREAUX L, et al. Clinical importance of changes in chronic pain intensity measured on an 11point numerical pain rating scale[J]. Pain, 2001, 94(2): 149-158.
- 6. PENG B, WU W, HOU S, et al. The pathogenesis of discogenic low back pain[J].J Bone Joint Surg Br, 2005, 87(1): 62-67.
- 7. ROBERTS S, EVANS H, TRIVEDI J, et al. Histology and pathology of the human intervertebral disc[J].J Bone Joint Surg Am, 2006, 88 Suppl 2:10-14.
- 8. GUYER RD, OHNMEISS DD. Lumbar discography. Position statement from the North American Spine Society Diagnostic and Therapeutic Committee[J]. Spine, 1995,20(18):2048-2059.
- 9. 吳建鋒,賈連順,李家順,等.腰椎MRI間盤(pán)信號(hào)及高度的改變與椎間盤(pán)源性腰痛的相關(guān)性研究[J].中國(guó)醫(yī)療前沿,2009,4(1):1-3.
- 10. BLACK W, FEJOS AS, CHOY DS. Percutaneous laser disc decompression in the treatment of discogenic back pain[J]. Photomed Laser Surg, 2004, 22(5):431-433.
- 11. CHOY DS.Percutaneous laser disc decompression: a 17year experience[J].Photomed Laser Surg, 2004,22(5):407-410.
- 12. MCMILLAN MR, PATTERSON PA, PARKER V. Percutaneous laser disc decompression for the treatment of discogenic lumbar pain and sciatica: a preliminary report with 3month followup in a general pain clinic population[J]. Photomed Laser Surg, 2004,22(5):434-438.
- 13. KAPURAL L, NG A, DALTON J, et al. Intervertebral disc biacuplasty for the treatment of lumbar discogenic pain: results of a sixmonth followup[J].Pain Med, 2008, 9(1):6067.
- 14. BOSWELL MV, TRESCOT AM, DATTA S, et al. Interventional techniques: evidencebased practice guidelines in the management of chronic spinal pain[J]. Pain Physician, 2007,10(1):107-111.