PLDD治疗腰椎间盘源性疼痛不同年龄段疗效观察.docVIP

PLDD治疗腰椎间盘源性疼痛不同年龄段疗效观察 　　doi：10.3969/j.issn.1007-614x.2014.16.29 　　摘 要 目的：评估经皮激光椎间盘减压术（PLDD）治疗腰椎间盘源性疼痛不同年龄段的疗效差异。方法：对63位通过核磁共振和椎间盘造影检查明确诊断的腰椎间盘源性疼痛患者，进行PLDD（采用NE-YAG激光）治疗。并参照MacNab手术评价标准评价术后疗效。术后随访3个月，观察不同年龄段的疗效。结果：在腰椎间盘源性疼痛的63位患者中，青年组显效率83.3%，明显高于年长组60.6%（P0.01）。青年组总有效率100%，高于年长组97%。且在3个月的随访中，未发现感染、血管损伤和临床严重合并症的病例。结论：使用NE-YAG激光的PLDD术是一种安全有效的治疗腰椎间盘源性疼痛方法，且针对较年轻患者更为适宜。 　　关键词 经皮激光椎间盘减压术 腰椎间盘源性疼痛 微创 　　Curative effect observation of PLDD in the treatment of lumbar discogenic pain in different age groups 　　Gong Chen，Pan Guichao，Shi Kesong，Qu Liang 　　Department of Orthopaedics and Traumatology，the Hospital of Integrated Chinese and Western Medicine of Changping District，Beijing 102200 　　Abstract Objective：To evaluate the curative effect difference of lumbar discogenic pain treated with percutaneous laser disc decompression（PLDD） in different age groups.Methods：63 cases with lumbar discogenic pain who were confirmed by nuclear magnetic resonance and discography were selected.They were treated with PLDD（NE-YAG laser）.We evaluated the postoperative curative effect according to MacNab operation evaluation standard.After surgery，follow-up time was 3 months.We observed the effect of different ages.Results：In the 63 cases with lumbar discogenic pain，the significant efficiency of youth group with 83.3% was higher than the older group with 60.6%（P0.01）.The efficiency of youth group with 100% was higher than the older group with 97%.And in the 3 months of follow-up，there was no infection，vascular injury and clinical serious complications.Conclusion：The PLDD using NE-YAG laser is a safe and effective treatment of lumbar discogenic pain，and it is more appropriate for younger patients. 　　Key words Percutaneous laser disc decompression；Lumbar discogenic pain；Minimally invasive 　　椎间盘源性疼痛是由椎间盘自身结构病变所引起的，可不伴有脊柱畸形和不稳定，属于非神经根性疼痛综合征。1984年美国的Choy，首先提出经皮激光椎间盘减压术（percutaneous laser disc decompression，PLDD）治疗椎间盘源性疾病的设想，并于1987年进行了首次内窥镜经皮激光腰椎间盘减压术的试验和临床应用[1]，取得满意的疗效，后西方各国纷纷效仿开展。而在我国自199