半導體激光減壓術治療椎間盤源性腰痛_《華西醫學》

作者：

余彬 ¹ , 楊志軍 ² , 李康仁 ¹ , 鄧寧 ¹

1成都市第三人民醫院骨科,四川成都 610041;2中國人民解放軍5701廠醫院, 四川成都 610031;

關鍵詞：

腰椎間盤源性腰痛激光腰椎間盤減壓術微創手術治療

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目的:評價經皮激光椎間盤減壓術(Semiconductor Percutaneous Laser Disc Decompression,PLDD)治療椎間盤源性腰痛的療效。方法:對我院采用SPLDD治療d的56例進行回顧性分析。經皮激光椎間盤減壓術(PLDD)治療椎間盤源性腰痛56例(70個椎間盤),每只椎間盤需激光能量如下:L3～4、L5～S1為:1 200～1 400J;L4～5為1300～1500J。比較手術前后疼痛強度數字等級 (pain intensity numerical rating scale, PINRS)評分,進行療效觀察和評定術后根據癥狀緩解程度。結果:隨訪3月為(2.1±0.4)分 (與術前比較,P lt;0.05);本組56例病例中,PINRS評分由術前平均(8.0±0.3)分改善到術后(2.0±0.2),共39例,占69.6%;(9.0±0.5)分改善到術后(4.0±0.6)共17例,占30.4%。未見椎間盤炎及其他并發癥發生。手術時間15～60m in,平均30 m in。結論:SPLDD治療椎間盤源性腰痛安全、有效、微創,值得推廣。

引用本文： 余彬,楊志軍,李康仁,鄧寧. 半導體激光減壓術治療椎間盤源性腰痛. 華西醫學, 2009, 24(6): 1393-1395. doi: 復制

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.經皮穿刺腰椎間盤半導體激光汽化減壓術的臨床應用[J]. 中醫正骨,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 11point 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間盤信號及高度的改變與椎間盤源性腰痛的相關性研究[J].中國醫療前沿,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 17year 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 3month followup 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 sixmonth followup[J].Pain Med, 2008, 9(1):6067.
14.	BOSWELL MV, TRESCOT AM, DATTA S, et al. Interventional techniques: evidencebased practice guidelines in the management of chronic spinal pain[J]. Pain Physician, 2007,10(1):107-111.

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.經皮穿刺腰椎間盤半導體激光汽化減壓術的臨床應用[J]. 中醫正骨,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 11point 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間盤信號及高度的改變與椎間盤源性腰痛的相關性研究[J].中國醫療前沿,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 17year 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 3month followup 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 sixmonth followup[J].Pain Med, 2008, 9(1):6067.
14. BOSWELL MV, TRESCOT AM, DATTA S, et al. Interventional techniques: evidencebased practice guidelines in the management of chronic spinal pain[J]. Pain Physician, 2007,10(1):107-111.

《華西醫學》

半導體激光減壓術治療椎間盤源性腰痛

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《華西醫學》

半導體激光減壓術治療椎間盤源性腰痛

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