椎间盘镜下钬激光治疗腰椎间盘突出症  

Micro Endoscopy Discectomy with Ho:YAG Laser in the Treatment of Lumbar Disc Herniation

作　　者：陈滨[1] 冯宇[1] 王涵韬[1] 刘祖德[1] 

机构地区：[1]上海交通大学医学院附属仁济医院骨科,上海200127

出　　处：《应用激光》2014年第3期269-271,共3页Applied Laser

摘　　要：目的：探讨椎间盘镜下钬激光治疗腰椎间盘突出症的临床疗效和应用价值。方法：前瞻性队列研究,2012年1月-12月间行椎间盘镜下钬激光治疗的30例患者纳入研究。采用Stryker椎间盘镜系统和Lumenis脉冲式钬激光。将椎间盘镜插入病变腰椎椎板后方,椎板钻孔,切除黄韧带,摘除游离的髓核,松解神经根,钬激光光纤引入椎间盘间隙,对髓核组织进行汽化。采用JOA评分评估临床疗效,术后3个月、1年分别门诊随访。结果：本组病例无并发症,无腰突症复发,J0A评分由术前（12.86±2.19）分,增加为术后3月的（25.14±1.35）分,以及术后1年的（24.73±3.12）分。无论术后3月以及1年,手术前后JOA评分差异均有统计学意义（P〈0.05）,总体手术疗效显著。结论：MED椎间盘镜技术与钬激光应用的结合,手术创伤小,神经根减压彻底,不扰乱脊柱稳定性,是一种微创治疗腰椎间盘突出症安全且行之有效的手术方法。Objectives：To evaluate the clinical effect of micro endoscopy discectomy with holmium laser in the treatment of lumbar disc herniation.Methods：Design was prospective cohort study.From Jan 2012to Dec 2012,30patients with lumbar disc hernia were treated with micro endoscopy discectomy and holmium laser using Stryker MED system and Lumenis Ho∶YAG laser system.The micro endoscopy system was inserted into the lamina and an operational channel was drilled to resect the ligament flavum,remove the free herniated nucleus and release the nerve root.Ho：YAG laser fiber was inserted into the inververtebral disc space and operate the vaporization of nucleus pulposus tissue.Evaluate the clinical efficacy of with JOA score after three months and 1year patient follow-up,respectively.Results：This group of patients with no complications and no lumbar herniation recurrence.Preoperative JOA score（12.86±2.19）increased after 3months post operation（25.14±1.35）and after1year（24.73±3.12）.Whether 3months and 1year after surgery,JOA score before and after surgery were statistically significant differences（P〈0.05）which show satisfactory clinical efficacy.Conclusions：MED discectomy combined with H laser application technology is a safe and effective methods for treatment of lumbar disc herniation with easy to mini-invasive,complete nerve root decompression,no disturbance of the stability of the spine.

关 键 词：钬激光 椎间盘镜 腰椎间盘突出 

分 类 号：R681.53[医药卫生—骨科学]