RESUMEN
A prospective study of 50 patients with low back and radicular pain caused by an L4-L5 protruded disc were treated by percutaneous laser nucleolysis with a carbon dioxide laser. The followup ranged from 2 to 5 years, and all the patients were evaluated clinically and by imaging with computed tomography scans and magnetic resonance images before and after the procedure. According to the Macnab criteria, 74% of the patients had excellent or good results and 26% had fair or poor results. The laser disc decompression opens up new options in the treatment of discogenic pain, but it is still an experimental procedure.
Asunto(s)
Discectomía Percutánea/métodos , Terapia por Láser/métodos , Dolor de la Región Lumbar/cirugía , Adolescente , Adulto , Dióxido de Carbono , Femenino , Humanos , Vértebras Lumbares , Masculino , Persona de Mediana Edad , Estudios ProspectivosRESUMEN
Percutaneous laser discectomy has developed as a new modality in the treatment of herniated intervertebral discs. An experimental study of percutaneous nucleolysis using a carbon dioxide laser beam was performed in 10 dogs, each dog having 2 intervertebral disc spaces treated, for a total of 20 discs. The intradiscal pressure decreased in all instances with the drop ranging from 10% to 55% at the L2-L3 disc and 40% to 69% at the L4-L5 disc. The macroscopic and microscopic studies showed vaporization of the nucleus pulposus, and in 8 spaces, thermal damage to the end plate was observed. This study suggests that carbon dioxide laser nucleolysis is easy and effective, but 300 J of laser energy can damage the end plates in some intervertebral discs in dogs.
Asunto(s)
Discectomía Percutánea/métodos , Disco Intervertebral/cirugía , Terapia por Láser/métodos , Vértebras Lumbares , Animales , Dióxido de Carbono , Perros , Disco Intervertebral/anatomía & histología , Terapia por Láser/efectos adversos , Fracturas de Salter-HarrisRESUMEN
Percutaneous transluminal angioplasty (PTA) of stenotic lesions in the distal abdominal aorta and its bifurcation was performed in 14 patients, 6 of whom were women. The stenotic segment in the aorta or aortic bifurcation was usually the only significant lesion. The double-balloon technique was used in 12 patients via bilateral femoral artery catheterizations. In 2 other patients with aortic lesions, a single large balloon sufficed. Good results were achieved in all but 1 patient, with minor complications occurring in 3 instances. The follow-up period varied from 6 months to 5 years. We believe that PTA is the procedure of choice in treating localized lesions of the distal abdominal aorta and its bifurcation, especially when distal vessels are relatively uninvolved.