Shekarchizadeh Ahmad, Mohammadi-Moghadam Ali, Rezvani Majid, Rahmani Peyman, Eshraghi Nourallah, Ghadimi Keyvan
Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences Isfahan, Iran.
Department of Research, School of Medicine, Isfahan University of Medical Sciences Isfahan, Iran.
Am J Neurodegener Dis. 2020 Dec 15;9(1):1-7. eCollection 2020.
The Percutaneous laser disc decompression (PLDD) method was first described by Daniel Choy in Australia in 1987. Therefore, in this study, we examined the clinical signs and symptoms of patients with spinal canal stenosis due to disc protrusion after PLDD surgery.
In this clinical trial study, 43 patients with spinal canal stenosis due to lumbar disks who referred to Kashani and Zahra Marzieh educational hospitals from 2006 to 2016 were entered the study. The patients were divided into two groups as discogenic canal stenosis (3 females and 9 males) and complex degenerative disorder (canal stenosis due to discogenic and ligamentos) (16 females and 15 males). Patients underwent PLDD surgery and the clinical manifestations such as back and radicular pain, claudication, and complications of the surgery (hematoma, reoperation, and neurological symptoms) in patients were evaluated until one year after the operation.
After one year of surgery, the mean of back and radicular pains significantly decreased in both groups (P<0.05). All patients with claudication in the discogenic group improved and 35.5% of patients with complex degenerative disorder were not claudication after one year of surgery. The outcomes of treatment in patients with discogenic canal stenosis were 91.7% excellent, and 8.3% fair and in the complex degenerative disorder group were 64.5% excellent, 19.4% good and 16.1% fair (P=0.16). None of the patients had new neurological symptoms, and 12.9% of the complex degenerative disorder group patients needed reoperation.
The PLDD method is a better procedure for discogenic canal stenosis than complex degenerative disorder. Therefore, more studies are required in this field for long time.
经皮激光椎间盘减压术（PLDD）于1987年由澳大利亚的丹尼尔·乔伊首次提出。因此，在本研究中，我们检查了PLDD手术后因椎间盘突出导致椎管狭窄患者的临床体征和症状。
在这项临床试验研究中，纳入了2006年至2016年转诊至卡沙尼和扎赫拉·玛齐耶教育医院的43例因腰椎间盘导致椎管狭窄的患者。患者分为两组，即椎间盘源性椎管狭窄组（3名女性和9名男性）和复杂退行性疾病组（因椎间盘源性和韧带性导致的椎管狭窄）（16名女性和15名男性）。患者接受了PLDD手术，并对患者的临床表现，如背部和神经根性疼痛、间歇性跛行以及手术并发症（血肿、再次手术和神经症状）进行了术后一年的评估。
术后一年，两组患者的背部和神经根性疼痛平均值均显著降低（P<0.05）。椎间盘源性组所有间歇性跛行患者均有改善，复杂退行性疾病组35.5%的患者术后一年无间歇性跛行。椎间盘源性椎管狭窄患者的治疗结果为91.7%优秀，8.3%一般；复杂退行性疾病组为64.5%优秀，19.4%良好，16.1%一般（P=0.16）。所有患者均无新的神经症状，复杂退行性疾病组12.9%的患者需要再次手术。
对于椎间盘源性椎管狭窄，PLDD方法比复杂退行性疾病的治疗效果更好。因此，该领域需要长期进行更多研究。
