PLDD治疗腰椎间盘突出症的治疗效果评估及其对脊柱的影响

发布时间：2018-03-21 12:59

本文选题：PLDD　切入点：治疗　出处：《青岛大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过对经皮穿刺激光减压术(PLDD)治疗腰椎间盘突出症患者的近期、中、远期临床症状、腰椎的影像学改变进行随访评估,分析PLDD治疗腰椎间盘突出症对腰椎稳定性的影响,评估PLDD治疗腰椎间盘突出症的临床治疗效果。方法:选取2013年2月--2014年11月在山东昌邑市人民医院行经皮穿刺激光减压治疗腰椎间盘突出症的82例患者,共135个椎间盘,按发病部位不同分为L4-L5组13例;L5-S1组16例;混合组53例。采用波长为1064nm的ND-YAG脉冲式激光行常规经皮穿刺激光减压术治疗。术后3、6、12、24个月进行随访,观察其临床症状、X线下椎间隙高度、椎体高度、椎间孔高度,测量其过伸过曲位相邻椎体位移,计算椎间高度指数,评估其椎间盘容积变化。研究PLDD治疗腰椎间盘突出症对腰椎稳定性的影响,分析其结果。结果:本组82例腰椎间盘突出症患者,共135个腰椎间盘突出(L4-L5组13例;L5-S1组16例;混合组53例)穿刺成功率100%。术后3、6、12、24个月进行随访,各组术后X线下椎间隙高度、术后椎体高度、椎体矢状位长度、椎间高度指数、椎间孔高度均示各个阶段无明显差异(p㧐0.05)。椎间盘容积:L4-L5组、L5-S1组、混合组均有显著差异(p0.05)。各组相邻椎体间位移(不同随访时间段):与手术前比较术后即刻、术后3月、术后6月、术后12月、术后24月无明显差异(p㧐0.05)。且与术前相比各个时间段位移均小于3mm。各组术后临床疗效:术后优良率较高,术后各个时间阶段疗效无明显差异(p㧐0.05)。结论:经皮激光减压术治疗腰椎间盘突出症近期、远期效果明显,且不影响脊柱稳定性,有利于患者早期恢复。是一种有效的微创治疗方法。
[Abstract]:Objective: to evaluate the recent, middle and long term clinical symptoms and imaging changes of lumbar disc herniation treated by percutaneous laser decompression, and to analyze the effect of PLDD on lumbar disc herniation. Methods: from February 2013 to November 2014, 82 patients with lumbar disc herniation were treated by percutaneous puncture laser decompression in Changyi people's Hospital, Shandong Province. The patients were divided into L4-L5 group (n = 13), L5-S1 group (n = 16) and mixed group (n = 53). Conventional percutaneous laser decompression was performed with ND-YAG pulse laser at 1064nm. The height of intervertebral space, the height of vertebral body and the height of intervertebral foramen were observed. The displacement of adjacent vertebrae was measured and the index of intervertebral height was calculated. To evaluate the changes of intervertebral disc volume, to study the effect of PLDD on lumbar disc herniation and to analyze the results. Results: in this group of 82 patients with lumbar disc herniation, there were 13 patients with L4-L5 lumbar disc herniation and 16 patients with L5-S1 group. The success rate of puncture was 100% in the mixed group (n = 100). All the patients were followed up for 24 months. The height of the intervertebral space, the height of the vertebral body, the length of the sagittal position, the index of the intervertebral height and the height of the intervertebral foramen showed no significant difference in each stage. The volume of intervertebral disc in group 1: L4-L5 was significantly different from that in group L5-S1, and there was no significant difference in the displacement of adjacent vertebrae between the two groups (different follow-up periods: immediately after operation, March, June, December, 24 months after operation). The displacement of each time period was less than 3mmm. the clinical effect of each group was higher than that of preoperation, and there was no significant difference in the curative effect at each time stage after operation. Conclusion: percutaneous laser decompression is an effective and minimally invasive method for the treatment of lumbar disc herniation.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3

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