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Percutaneous laser uncleotomy for lumbar disc herniation ; basic studies and clinical results

经皮激光切除术治疗腰椎间盘突出症；

基本信息

批准号：
05671238
负责人：
ONOMURA Toshinobu
金额：
$ 0.77万
依托单位：
Osaka Medical College
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1993
资助国家：
日本
起止时间：
1993 至 1994
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-05671238/
关键词：
laser disc herniation percutaneous vaporization decompression MRI intradiscal pressure

项目摘要

Percutaneous laser nucleotomy has been studied in authors' laser laboratory. This investigation is composed of basic studies (three parts) and the short term clinical results. Basic study 1. Dog discs were used and intradiscal pressures (IDP) and MRI findings were investigated. IDP and MRI signals were dicreasing according to laser irradiations but there were no correlations between IDP and MRI signals. Basic study 2. Goat lumbar discs were used and the heat distributions were evaluated. The temperature at the center of the nucleus pulposus rose high but the edge of the discs indicated no dangerous thermal distribution. Basic study 3. Chronic histological changes after laser irradiation were observed by light microscopic observation. These histological changes are the same as the changes of conventional study. After confirming the safety through these animal studies, we have started clinical trials of PLN for lumbar disc herniation. Results demonstrated this procedure was hopeful as an alternative to open surgery in case patient selection was carefully performed. The mechanism of pain-relief with PLN is speculated as the reduction of intra-discal pressure and/or the shrinkage of the herniated mass. The early series of PLN provided a relatively low rate of success (50%), however the procedure is relatively simple to perform, and has less associated postoperative complication. PLN is an effective, safe, short-time consuming, and less invasive treatment for protruded lumbar disc herniation in case patient selection is carefully performed. The success rate will increase with more meticulous patient selection, and it may become a more practical choice of treatment for lumbar disc herniation. Further investigation is necessary to detect the relationship between the anatomical appearance of disc and PLN outcome.

经皮激光髓核摘除术已在作者的激光实验室进行了研究。本研究由基础研究（三部分）和短期临床结果组成。基础研究1。使用犬椎间盘，研究椎间盘内压（IDP）和MRI结果。IDP和MRI信号随激光照射量的增加而降低，但两者之间无相关性。基础研究2。使用山羊腰椎间盘并评估热分布。髓核中心的温度升高，但盘的边缘没有显示危险的热分布。基础研究3。光镜观察激光照射后慢性组织学变化。这些组织学变化与常规研究的变化相同。在通过这些动物研究确认安全性后，我们开始了PLN治疗腰椎间盘突出症的临床试验。结果表明，在仔细选择患者的情况下，该手术有望作为开放手术的替代方案。PLN缓解疼痛的机制被推测为椎间盘内压力的降低和/或突出肿块的收缩。早期系列PLN的成功率相对较低（50%），但手术相对简单，相关术后并发症较少。PLN是一种有效、安全、耗时短、创伤小的治疗腰椎间盘突出症的方法。随着患者选择的更加细致，成功率将提高，它可能成为腰椎间盘突出症更实用的治疗选择。进一步的研究是必要的，以检测椎间盘的解剖外观和PLN的结果之间的关系。