Stith W J, Judy M M, Hochschuler S H, Guyer R D
Texas Back Institute Research Foundation, Plano.
Orthop Rev. 1991 Feb;20(2):137-42.
Recently, there has been increased interest in less invasive spinal surgery techniques. This has led to the development of procedures such as automated percutaneous lumbar discectomy and arthroscopic microdiscectomy. Lasers are now used in many areas of medicine and may have applications in minimally invasive spinal surgery. A number of different laser systems have been evaluated for their effectiveness in removing disc tissue in the laboratory, but technical problems have limited their clinical use. Only the Nd:YAG (1,064 nm and 1,320 nm) and KTP (532 nm) systems have been used clinically. Unsuccessful clinical results were obtained with the 1,064 nm Nd:YAG, whereas the other two systems appeared to produce results similar to the present mechanical systems but required less time for disc removal. This paper discusses considerations for choosing a laser system for spinal applications and reviews the work performed in this area.
最近，人们对侵入性较小的脊柱手术技术越来越感兴趣。这促使了诸如自动经皮腰椎间盘切除术和关节镜下显微椎间盘切除术等手术的发展。激光目前已应用于医学的许多领域，并且可能在微创脊柱手术中有应用。许多不同的激光系统已在实验室中评估了其在去除椎间盘组织方面的有效性，但技术问题限制了它们的临床应用。只有钕钇铝石榴石（Nd:YAG，波长1064纳米和1320纳米）和磷酸钛钾（KTP，波长532纳米）系统已在临床上使用。1064纳米的钕钇铝石榴石系统临床效果不佳，而其他两个系统似乎产生的结果与目前的机械系统相似，但椎间盘切除所需时间更短。本文讨论了为脊柱应用选择激光系统的注意事项，并回顾了该领域所做的工作。
