The clinical application of percutaneous laser disc decompression in the treatment of cervical disc herniation / 中华骨科杂志

Objective To review the clinical results of percutaneous laser disc decompression(PLDD)in the treatment of cervical disc herniation.Methods PLDD was adopted in the treatment of cer-vi cal disc herniation in32patients.There were19males and13females with an average age of 54years,ranging from33to67years.The lesions were located at the levels of C 3,4 in4cases,C 4,5 in11cases,C 5,6 in13cases and C 6,7 in7cases.The laser fiber was introduced into the herniated disc space with the needle puncturing percu taneously in anterior surface of neck under fluoroscopic guidance.The ND:YAG laser was of 1060nm wave-length,and the diameter of the fiber was400?m.The laser output power was15w with1s emission and5s interval.The compression of spinal cord and surrounding tissue was eliminated by reducing the intra-disc pressure through the vaporization of the disc nucleus.The total laser output power was decid ed depending on the age of the patients,degenerative degree of the disc and the reactive process of heat.The total powers of the group were360J to1100J.Results The mean follow-up was8months,ranging from3to15months.The clinical evaluations were classified as excellent in16cases(50%),good8cases(25%),fair4cases(12.5%)and poor 4cases(12.5%).The general effective ratio was87.5%,the ex cellent and good ratio was75%.The remission ratio of the symptoms was80.7%for the neck and shoulder pain,84.2%for ra-diating pain of the nerve roots of upper extremities,60%for symptoms of the lower ex tremities and78.5%for cervi cal dizziness.No complications occured.Conclusion PLDD could relieve the symptoms and signs of patients cervical disc herniaton.PLDD is easy to manipulate,safe,mini-invasive,and the patients recov-ered sooner with less complications.