CAJ | 학술논문

背景:经皮激光椎间盘减压术是一项脊柱微创手术新技术,逐步在临床广泛应用.目的:评价经皮激光椎间盘减压术对颈椎稳定性的影响.设计:以患者为研究对象,前后对照观察研究.单位:暨南大学附属第二医院深圳市人民医院脊柱外科.对象:2001-10/2003-04暨南大学附属第二医院深圳市人民医院脊柱外科收治侧旁型颈椎间盘突出症患者28例,29个椎间盘,男17例,女11例.干预:在X射线监视下,9号穿刺导针颈前穿刺,将400μm光导纤维导入病损椎间盘内,使用波长1060nm的ND:YAG激光,输出功率15 W,对髓核进行汽化、减压,接受激光剂量为500～950 J.主要观察指标:观察治疗前及术后6个月手术椎间盘相邻椎体前后横向位移及成角情况.结果:过屈位、过伸位手术前后手术椎间盘相邻椎体的位移差异无显著性意义(t=0.8117～0.827 2,P＞0.05);其相邻椎体角度大小差异无显著性意义(t=0.768 7～0.827 1,P＞0.05).结论:经皮激光椎间盘减压术治疗侧旁型颈椎间盘突出症,操作简易,损伤小,影响颈椎稳定性.
배경:경피격광추간반감압술시일항척주미창수술신기술,축보재림상엄범응용.목적:평개경피격광추간반감압술대경추은정성적영향.설계:이환자위연구대상,전후대조관찰연구.단위:기남대학부속제이의원심수시인민의원척주외과.대상:2001-10/2003-04기남대학부속제이의원심수시인민의원척주외과수치측방형경추간반돌출증환자28례,29개추간반,남17례,녀11례.간예:재X사선감시하,9호천자도침경전천자,장400μm광도섬유도입병손추간반내,사용파장1060nm적ND:YAG격광,수출공솔15 W,대수핵진행기화、감압,접수격광제량위500～950 J.주요관찰지표:관찰치료전급술후6개월수술추간반상린추체전후횡향위이급성각정황.결과:과굴위、과신위수술전후수술추간반상린추체적위이차이무현저성의의(t=0.8117～0.827 2,P＞0.05);기상린추체각도대소차이무현저성의의(t=0.768 7～0.827 1,P＞0.05).결론:경피격광추간반감압술치료측방형경추간반돌출증,조작간역,손상소,영향경추은정성.
BACKGROUND: As a novel procedure in minimally invasive spine surgery (MISS), percutaneous laser disc decompression(PLDD) has been applied widely in the recent development in clinical practices.OBJECTIVE: This study was designed to evaluate the influences of PLDD on the stability in cervical spinal constructs.DESIGN: A before-after comparison trail based on patients.SETTING: The experiment was performed at the spine surgery department of a hospital affiliated to a university.PARTICIPANTS: Twenty-eight patients who were diagnosed as lateral cervical disc herniation at the Spine Surgery Department of Shenzhen People' s Hospital, Second Hospital Affiliated to Jinan University were involved from October 2001 to April 2003. Of all of the patients, 17 were male and 11 were female. They have 29 cervical disc protrusions altogether.INTERVENTIONS: Monitored by X-ray, a 400 μm fixed optical fiber was introduced into the injured intervertebral disc via a 9-gauge flexible trocar through an anterior cervical approach. An Nd-YAG laser system,with a 1 060 nm wavelength and an output power of 15W, was employed to ablate or decompress the inner disc tissue. The disc tissue was exposedto 500- 950 J laser powers.MAIN OUTCOME MMEASURES: Before and 6 months after the PLDD, the deviation of adjacent vertebra displacements was observed and changings of the wedge angles of the intervertebral discs were calculated respectively.RESULTS: The deviation of adjacent vertebra displacements showed no significant difference between before and after operation, when the patients were examined with a more flexed-position or a more extended-position(t=0.811 7-0.827 2, P＞ 0.05), and no significant changes in the wedge angles of the intervertebral discs could be observed either(t=0.768 7-0.827 1,P ＞ 0.05).CONCLUSION: Applying percutaneous laser disc decompression to lateral cervical disc herniation has many advantages, such as simplicity of operation, minimal invasion and having no impact on the stability in cervical spinal constructs.