CT引导下经皮激光切割椎间盘术加臭氧氧化髓核术联合治疗颈.腰椎间盘突出症.docVIP

CT引导下经皮激光切割椎间盘术加臭氧氧化髓核术联合治疗颈.腰椎间盘突出症 发表时间：2008-12-28发表者：王明明 (访问人次：283) ? ????????? ??王明明? 周四学? 李辉? 王勇? 唐元德 占祥友 刘灵军 张鑫晟 ? 【 摘要】 目的 ?探讨经皮激光椎间盘气化术（PLDD）加臭氧（O3）髓核氧化术联合治疗腰椎间盘突出症的疗效 方法? 应用医用半导体激光（功率3~15W，波长980nm），医用臭氧发生器，在CT引导下采用18G穿刺针经皮穿刺至髓核区，然后由穿刺针插入600um光导纤维，用自动脉冲式激光切割、汽化髓核，以每个椎间盘600~800J切割、汽化，再向椎间盘內注入浓度为60ug/mlO3约8~12ml，共治疗216例319节椎间盘。疗效判定标准采用Macnab的标准［1]。结果 ?随访3-30个月后，216例患者术中，有147例疗效为优，59例为良，6例为有效，4例为差；优良率：95.4%，有效率2.8%，差1.8%。，无任何严重的并发症发生。结论? 经皮激光椎间盘汽化术加臭氧髓核氧化术组合治疗治疗腰椎间盘突出症，具有创伤小，痛苦少，安全性高，疗效佳的特点，值得在临床上推广。 ? 关健词??? 激光椎间盘汽化术 ?臭氧? 髓核氧化术? 腰椎间盘突出症 ?联合治疗 ? Percutaneous Laser Disk Decompression Combining Ozone Nucleus Gelatinosus Oxidizing Technique Treats Lubar Intervertebral Disc Protrusion 【Abstract】 Objective ?To explore the therapeutic effects of Percutaneous Laser Disk Decompression(PLDD) combining Ozone Nucleus Gelatinosus Oxidizing Technique to treat Lubar Intervertebral Disc Protrusion (LIDP). Methods Under CT guidance, the spinal needle was inserted in the space of the nucleus gelatinosus. 216 patients with 319 intervertebral disks were treated by auto pulsed-wave mode laser cutting and vaporizing (with the power of? 600-800 J for each intervertebral disk) and then O3 (8-12 ml with concentration of 60ug/ml) was influxed. Therapeutic effects were judged by Macnab’ standard. ?Results ?Among the total 216 patients with ?the follow up of 3 to 30 months, 147 patients had excellent therapeutic effects, 59 patients had good therapeutic effects,6 patients had some therapeutic effects and 4 patients had no therapeutic effects. The total excellent and good effective rate is 94.5%, 2.8% with some therapeutic effects and 1.8% with no therapeutic effects. No complications were occurred among the patients. Conclusion The method that Percutaneous Laser Disk Decompression(PLDD) combining Ozone Nucleus Gelatinosus Oxidizing Technique treats Lubar Intervertebral Disc Protrusion, with advantages of little injury and pain, high safety and better therapeutic effect, can be widely