中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2010年
2期
116-119
,共4页
任龙喜%郭保逢%张彤童%白秋铁
任龍喜%郭保逢%張彤童%白鞦鐵
임룡희%곽보봉%장동동%백추철
激光疗法%椎间盘移位%随访研究%影像学
激光療法%椎間盤移位%隨訪研究%影像學
격광요법%추간반이위%수방연구%영상학
Laser therapy%Intervertebral disk displacement%Follow-up studies%Imageology
目的 观察经皮激光椎间盘减压术(PLDD)后中期随访影像学变化,评价该手术的安全性和有效性.方法 回顾性分析经PLDD治疗的22例颈腰椎病患者的临床资料,其中男性10例,女性12例;年龄44～73岁,平均58岁;随访时间36～54个月,平均41.5个月.椎间盘分布:颈椎12例27个,腰椎10例22个;其中C_(3～4)3个,C_(4～5)8个,C_(5～6)10个,C_(6～7)个,L_(2～3)2个,L_(3～4)2个,L_(4～5)9个,L_5S_1 9个.在侧位x线片应用手术椎间隙高度与椎体高度比值观察手术前后病变椎间隙高度变化;在MRI横断面上,应用椎间盘突出指数观察手术间盘突出情况的变化,并对结果进行统计学分析.结果 术后末次随访病变椎间盘椎间隙前缘高度、中心高度及后缘高度较术前无明显变化(P>0.05).颈椎间盘病变节段突出指数术前为0.10～0.54,术后末次随访为0.06～0.39,差异有统计学意义(P<0.05);腰椎间盘病变节段突出指数术前为0～0.71,末次随访为0～0.48,差异有统计学意义(P<0.01).结论 PLDD术后对椎间隙高度没有明显影响,该手术能有效促进椎间盘突出物的缩小.从影像学上分析,PLDD是治疗颈腰椎病的一种安全有效的微创手术.
目的 觀察經皮激光椎間盤減壓術(PLDD)後中期隨訪影像學變化,評價該手術的安全性和有效性.方法 迴顧性分析經PLDD治療的22例頸腰椎病患者的臨床資料,其中男性10例,女性12例;年齡44～73歲,平均58歲;隨訪時間36～54箇月,平均41.5箇月.椎間盤分佈:頸椎12例27箇,腰椎10例22箇;其中C_(3～4)3箇,C_(4～5)8箇,C_(5～6)10箇,C_(6～7)箇,L_(2～3)2箇,L_(3～4)2箇,L_(4～5)9箇,L_5S_1 9箇.在側位x線片應用手術椎間隙高度與椎體高度比值觀察手術前後病變椎間隙高度變化;在MRI橫斷麵上,應用椎間盤突齣指數觀察手術間盤突齣情況的變化,併對結果進行統計學分析.結果 術後末次隨訪病變椎間盤椎間隙前緣高度、中心高度及後緣高度較術前無明顯變化(P>0.05).頸椎間盤病變節段突齣指數術前為0.10～0.54,術後末次隨訪為0.06～0.39,差異有統計學意義(P<0.05);腰椎間盤病變節段突齣指數術前為0～0.71,末次隨訪為0～0.48,差異有統計學意義(P<0.01).結論 PLDD術後對椎間隙高度沒有明顯影響,該手術能有效促進椎間盤突齣物的縮小.從影像學上分析,PLDD是治療頸腰椎病的一種安全有效的微創手術.
목적 관찰경피격광추간반감압술(PLDD)후중기수방영상학변화,평개해수술적안전성화유효성.방법 회고성분석경PLDD치료적22례경요추병환자적림상자료,기중남성10례,녀성12례;년령44～73세,평균58세;수방시간36～54개월,평균41.5개월.추간반분포:경추12례27개,요추10례22개;기중C_(3～4)3개,C_(4～5)8개,C_(5～6)10개,C_(6～7)개,L_(2～3)2개,L_(3～4)2개,L_(4～5)9개,L_5S_1 9개.재측위x선편응용수술추간극고도여추체고도비치관찰수술전후병변추간극고도변화;재MRI횡단면상,응용추간반돌출지수관찰수술간반돌출정황적변화,병대결과진행통계학분석.결과 술후말차수방병변추간반추간극전연고도、중심고도급후연고도교술전무명현변화(P>0.05).경추간반병변절단돌출지수술전위0.10～0.54,술후말차수방위0.06～0.39,차이유통계학의의(P<0.05);요추간반병변절단돌출지수술전위0～0.71,말차수방위0～0.48,차이유통계학의의(P<0.01).결론 PLDD술후대추간극고도몰유명현영향,해수술능유효촉진추간반돌출물적축소.종영상학상분석,PLDD시치료경요추병적일충안전유효적미창수술.
Objective To study the imaging findings outcome of the percutaneous laser disc decompression (PLDD) and evaluate the middle-term safety and efficacy of PLDD. Methods The imaging datas of 22 eases suffered cervical spondylosis or lumbar spondylosis and treated by PLDD more than 3 years were retrospectively reviewed. To observe the intervertebral space of the iuvasive disc and the intervertebral disc hernia before and after the operation on the lateral projection of X-ray and the axial view of the MRI. To make a statistical analysis of the dates. Results There was no obvious change of disc height involving the anterior disc height, the intermediate disc height and the posterior disc height after the PLDD at the final follow-up(P>0. 05). At last time follow-up, the Sagittal Index(SI) are 0. 10-0. 54 and 0. 06-0. 39 before and after the PLDD in the treatment of cervical vertebra. The statistical difference were significant (P<0.05). In lumbar vertebra, the SI is 0-0.71 and 0-0.48 disc before and after the PLDD. The statistical difference were very significant (P< 0. 01 ). Conclusions The PLDD will not destroy the intervertebral space of the cervical and lumbar vertebra obviously; moreover, it can effectively reduce the diskal hernia. The PLDD is a safe and effective Mini-invest surgery for cervical vertebra and lumbar vertebra diseases.
