Outcome of patients with lumbar spinal canal stenosis due to discogenic under percutaneous laser disc decompression.

American journal of neurodegenerative disease Pub Date : 2020-12-15 eCollection Date: 2020-01-01
Ahmad Shekarchizadeh, Ali Mohammadi-Moghadam, Majid Rezvani, Peyman Rahmani, Nourallah Eshraghi, Keyvan Ghadimi
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Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

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经皮激光椎间盘减压术治疗椎间盘源性腰椎管狭窄的疗效。
背景:经皮激光椎间盘减压术(PLDD)由Daniel Choy于1987年在澳大利亚首次提出。因此,在本研究中,我们研究了PLDD手术后椎间盘突出导致椎管狭窄患者的临床体征和症状。方法:本临床试验研究纳入2006 - 2016年在Kashani和Zahra Marzieh教育医院转诊的43例腰椎间盘狭窄患者。患者分为椎间盘源性椎管狭窄组(女性3例,男性9例)和复杂退行性疾病(椎间盘源性和韧带性椎管狭窄)组(女性16例,男性15例)。接受PLDD手术的患者,评估患者的临床表现,如背部和神经根疼痛、跛行以及手术并发症(血肿、再手术、神经系统症状),直至术后1年。结果:术后1年,两组患者腰痛和神经根痛的平均值均显著降低(p)。结论:PLDD法治疗椎间盘源性椎管狭窄优于复杂退行性疾病。因此,在很长一段时间内,这一领域还需要进行更多的研究。
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