Buchelt M, Katterschafka T, Horvat R, Kutschera H P, Kickinger W, Laufer G
Department of Orthopedic Surgery, University of Vienna, Austria.
Lasers Surg Med. 1991;11(3):280-6. doi: 10.1002/lsm.1900110312.
Laser induced fluorescence of intervertebral discs was investigated in this study for the first time in order to develop a fluorescence guided percutaneous excimer laser discectomy. For this purpose 35 human cadaveric intervetebral discs from level L1 to L5 were irradiated with a 308 nm XeCl excimer laser with a 60 nsec pulse width at 10, 20 and 30 mj/mm2. Laser light was transmitted over a 1000 microns core optical fiber. Fluorescence emitted from the irradiated tissue was transmitted back over the same fiber over a semireflective mirror to another optical fiber, coupled into a spectrograph and O-SMA optical simultaneous multichannel spectral analyzer system. The spectral lineshape of both the annulus fibrosus and the nucleus pulposus was characterized by a broadband emission between 320 nm and 616 nm with 3 peak emissions at 358, 423 and 457 nm. Relative intensities were calculated by forming two ratios of the peak intensities of the three peaks (R1 = I 423/I 358; R2 = I 423/I 457). Statistical analysis of both ratios revealed a highly significant discrimination between annulus fibrosus and nucleus pulposus (P less than 0.001). Under penetrating conditions multiple recorded spectra showed the spectral profile of subsequently ablated nucleus and annulus. The results of this study demonstrate that discrimination between annulus fibrosus and nucleus pulposus by excimer laser-induced fluorescence is feasible under laboratory conditions. Fluorescence spectroscopy could possibly be developed into a valuable guiding system for percutaneous laser discectomy.
本研究首次对椎间盘的激光诱导荧光进行了研究，目的是开发一种荧光引导的经皮准分子激光椎间盘切除术。为此，使用脉冲宽度为60纳秒的308纳米XeCl准分子激光，以10、20和30毫焦/平方毫米的能量密度，对35个从L1到L5节段的人类尸体椎间盘进行照射。激光通过一根1000微米芯径的光纤传输。照射组织发出的荧光通过同一根光纤，经半反射镜反射回另一根光纤，耦合到光谱仪和O-SMA光学同步多通道光谱分析仪系统。纤维环和髓核的光谱线形特征为在320纳米至616纳米之间有宽带发射，在358、423和457纳米处有3个峰值发射。通过形成三个峰值强度的两个比值（R1 = I 423/I 358；R2 = I 423/I 457）来计算相对强度。对这两个比值的统计分析显示，纤维环和髓核之间存在高度显著的差异（P小于0.001）。在穿透条件下，多次记录的光谱显示了随后被消融的髓核和纤维环的光谱特征。本研究结果表明，在实验室条件下，通过准分子激光诱导荧光区分纤维环和髓核是可行的。荧光光谱学有可能发展成为经皮激光椎间盘切除术的一种有价值的引导系统。
