经小关节内侧缘径路激光腰椎间盘减压术的临床研究  

Percutaneous Laser Disc Decompression Through Internal Edge of Lumbar Small Joint

作　　者：周建斌[1] 张愈峰[2] 朱玉健 陈飞[1] 

机构地区：[1]江苏省丹阳市中医院疼痛科,212300 [2]南通大学附属医院分院疼痛诊疗中心

出　　处：《中国骨与关节损伤杂志》2007年第11期896-898,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的研究经小关节内侧缘径路激光腰椎间盘减压术的疗效与穿刺成功率。方法将66例腰椎间盘突出症随机分成两个治疗组:改良组——经小关节内侧缘径路(A组),传统组——后外侧径路(B组)。A组在CT监测下找到最大椎板后间隙,用新型激光汽化穿刺针经小关节内侧缘穿入椎间盘内,导入激光光纤汽化摘除部分椎间盘。B组在CT监测下用16G穿刺针从后外侧穿入椎间盘内,导入激光光纤汽化摘除部分椎间盘。于治疗后3个月时评定疗效。结果优良率:A组81.82%,B组78.79%。有效率:A组90.91%,B组87.88%。经检验P>0.05,差异无显著性。一针穿刺成功率:L4、5椎间盘为A组80.77%,B组96.30%,经检验P<0.05,差异有显著性;L5S1椎间盘为A组94.74%,B组76.47%,经检验P<0.05,差异有显著性。结论经小关节内侧缘径路与传统径路激光腰椎间盘减压术的疗效同样显著。一针穿刺成功率:L4、5传统径路优于经小关节内侧缘径路;L5S1经小关节内侧缘径路优于传统径路。Objective To observe the therapeutic effect and the successful puncture rate of pereutaneous laser disc decompression through the internal edge of lumbar small Joint. Methods Sixty- six patients were randomly divided into two treatment groups. One was the modification group through the internal edge of small joint （ group A） and the other was the traditional group through the posterior and the lateral edge （ group B）. Group A was examined by CT to find the biggest hole behind the lamina. The new type laser steamy puncture needle was inserted in the intervertebral disc through the internal edge of small joint, and the laser fibre was inserted to remove the part of the intervertebral disc. Group B was examined by CT. The 16 G puncture needle was inserted in the intervertebral disc through the posterior and lateral edge, and the laser fibre was inserted to rmove the part of the intervertebral disc. The therapeutic effect after the treatment of 3 months was assessed. Results The cured and obviously effective rate was 81.82 % in group A and 78.79 % in group B. The effective rate was 90.91% in group A and 87.88% in group B. There was no significant difference. The successful puncture rate with one needle was 80.77% in group A and 96.30% in group B for L4、5, 94.74% in group A and 76.47% in B group for L5S1. there were significant differences by test （P〈0.05）. Conclusion There is the same significant therapeutic effect in group A and B. The successful puncture rate with one needle, the traditional approach is better than the approach through the internal edge of small joint of L4、5. The approach through the internal edge of small joint is better than the traditional approach for L5S1.

关 键 词：经小关节内侧缘 激光 腰椎间盘减压术 

分 类 号：R681.53[医药卫生—骨科学]