PERCUTANEOUS LASER DISK DECOMPRESSION - A NEW THERAPEUTIC MODALITY

被引：129

作者：

CHOY, DSJ

ASCHER, PW

RANU, HS

SADDEKNI, S

ALKAITIS, D

LIEBLER, W

HUGHES, J

DIWAN, S

ALTMAN, P

机构：

[1] St. Luke’s/Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY

[2] Neurosurgical Department, University of Graz, Graz

来源：

SPINE | 1992年 / 17卷 / 08期

关键词：

PERCUTANEOUS; LASER; INTERVERTEBRAL DISK; INTRADISCAL PRESSURE; DISK DECOMPRESSION; DISK HERNIATION; LOW BACK PAIN; SCIATICA; DISK DENATURATION;

D O I：

10.1097/00007632-199208000-00014

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

The authors present a new advance in the treatment of herniated disc disease using percutaneous Nd:YAG laser to vaporize a small portion of nucleus pulposus, thereby decompressing the disc. In vitro and in vivo animal data are presented. Three hundred seventy-seven magnetic resonance imaging or computed tomography scan-documented, herniated, nonsequestered lumbar intervertebral discs with corresponding clinical findings in 333 patients were so treated in an outpatient setting. The longest follow-up was 62 months, with a mean of 26 months. According to the Macnab criteria, there was a good to fair response in 261 patients (78.4%), and a poor response in 72 (21.6%); 166 patients experienced relief of pain during the procedure. One-third of repeat magnetic resonance imaging scans at 4-6 months postlaser treatment showed modest to moderate decrease of disc herniation.

引用

页码：949 / 956

页数：8

共 27 条

[1]

Adams M.A., Hutton W.C., Mechanics of the intervertebral disc. The Biology of the Intervertebral Disc, (1989)

[2]

Choy D., Ascher P.W., Case R.B., Kaplan M., Eron L., Percutaneous Laser Nucleolysis of Lumbar Discs. Nd: YAG Laser in Medicine & Surgery: Fundamental and Clinical Aspects, pp. 363-369, (1986)

[3]

Choy D., Case R.B., Fielding W., Percutaneous laser nucleolysis of lumbar disc, N Engl J Med, 317, pp. 771-772, (1987)

[4]

Choy D., Case R.B., Fielding W., Hughes J., Ascher P.W., Percutaneous Laser Ablation of Lumbar Discs: A Preliminary Report of in Vitro and in Vivo Experience in Animals and Four Human Patients, (1987)

[5]

Choy D., Altman P.A., Case R.B., Trokel S.L., Interaction of laser radiation with human intervertebral disc at wavelengths of 193 nm, 488 nm, 514 nm, 1064 nm, 1318 nm, 2150 nm, 2940 nm, and 10600 nm, Clin Orthop, 267, pp. 245-250, (1990)

[6]

Crawshaw C., Frazer A.M., Merriam W.F., Mulholland R.C., Web J.C., A comparison of surgery and chemonucleolysis in the treatment of sciatica: A prospective randomized trial, Spine, 9, (1984)

[7]

Ejeskar A., Nachemson A., Herberts P., Surgery versus chemonucleolysis for herniated lumbar discs: A prospective study with random assignments, Clin Orthop, 174, pp. 236-242, (1983)

[8]

Gropper G.R., Robertson J.H., McClellan G., Comparative histological and radiographic effects of C 02 laser versus standard surgical anterior cervical discectomy in the dog, Neurosurgery, 1, pp. 42-47, (1984)

[9]

Hijikata S., Yamiagishi M., Nakayama T., Percutaneous discectomy: A new treatment method for lumbar disc herniation, Toden Hosp, 5, pp. 5-13, (1975)

[10]

Holbrook R.L., Grozier K., Kelsey J.L., The Frequency of Occurrence, Impact, and Cost of Selected Musculoskeletal Conditions in the United States, pp. 154-156, (1984)

← 1 2 3 →