| LDH is a common and frequently-occurring disease.Among 100 people, there will be 15 people suffer from it.Doctors often use traditional methods such as traction,massage,surgery or minimally insasive methods such as CCNL,APLD,PLDD to cure it.Compared with the traditional ones, PLDD has advantages of simplicity,convenience,minimal trauma and without serious complications.Research targetobject:To research the experimental animals and patients in the hospital and statistically analyze the pressure,cubage and temperature obtained from PLDD operation,we can estimate the curative effect of PLDD according to the MacNab and JOA criterion.Material and methodMethod1 Grouping MethodAccording to the differences between animal models,we can divide them into two groups---experiment group(group A)and contrast group(group B).Group A:Measuring the pressure of disc by the single-point PLDD;Group B:Measuring the pressure of disc by the multi-point PLDD.Apply stochastic method to establish the curative scheme---group A first,then the group B,or on the contrary.2.Reserch method①Lying down on one side with sick limb up;②Puncture point: puncture needle and the body sagittal section are at an angle of 45°～60°.Local anaesthesia:Take 5ml～10ml 0.5ml～1.0ml lidocaine to do the local infiltration anaesthesia through derma,hypoderm,muscle and vertebra joint.No anaesthesia the nerve root.Treatment Method1.Animal reserch:If the needle meets the bony resister,pull it back a little to the outer part,then the needle will slide to the disc,when the needle insert the disc velamen and A.F,the patient will feel a slight pain,and then the resister disappears,the pain will fade away when the needle gets to the marrow core.To locate the position of the needle by X-Ray from the normotopia and lateral position of lumber respectively.Normotopia is in the center of disc.Fiber optic laser inserts the lumbar 5mm deeper than the puncture needle,6mm deeper than the top of fibrin,therefore,the centre position of cauterization is in the 10mm front of the centre of the puncture needle.If we pull the needle 10mm back,the marrow core will be cauterized and boiled away.To insert the needle in the symmetric part of uninjured part and injured part,and connect the pressure pickup to check the pressure,and then we can compare the differences of the pressures in the disc before and after PLDD(See the profile).2.Clinical Reserch:Laser irradiation:the laser irradiation happens once every two seconds,if the patient' hurt in waist and legs,it is because of the heat of vaporization,then we pull out the fiber optic laser,wait for a few seconds to fade away the heat,thereafter we continue to operate by delivering the power in 1000J.The target of laser cutoff:①patient feels hurt,overheating;②the top of the laser fiber adhering carbonization;③the smell of burnt protein;④the top of the fiber optic laser appears matchstick like changes.The treatment after laser irradiation:to pull out the fiber optic laser to control the traumatic inflammation in the disc,and inject glucocorticoid into disc.To pull out the puncture needle,and cover it with the pledget.The patient lies on his back to accept the SLR examination,toe myodynamic examination and sense examination.70%of the patients improved obviously after the operation,patients are asked to wear the soft kummerbund for 3 weeks,be in hospital for 3 days.Stat.methods and data processTo adopt SPSS10.0 software,all the data is checked by bilateral statistic method.If P≤0.05,the checked differences are significative.Conclusion1 Conclusion of animal research1.1 The relationship between the efficiency of PLDD and the patients' age:the younger the patient is,more effective of the PLDD,especially for patients under 40 years old,which can reach 93%.1.2 The relationship between the efficiency of PLDD and the course of diseases:The shorter the course is,more effective the PLDD is, especially for the course which less than 2 years,reaching 88%.Of the 88%,there are 19%patients' discs recover to a certain extent in 3 moths.1.3 The relationship between the efficiency of PLDD and severity of LDH: the less serious the disease is,the more effective the PLDD is.PID＜6mm,the efficiency can reach 90%.1.4 The relationship between the efficiency of PLDD and the course of diseases after the operation,the second day after the operation,the efficiency will reach 86%,more than 79%after one week,the disease will be stable after three months.2 Conclusion of clinical research2.1 The relationship between the efficiency of PLDD and the patients' age:the younger the patient is,more effective of the PLDD,especially for patients under 40 years old,which can reach 93%.2.2 The relationship between the efficiency of PLDD and the course of diseases:The shorter the course is,more effective the PLDD is, especially for the course which less than 2 years,reaching 88%.Of the 88%,there are 19%patients' discs recover to a certain extent in 3 moths.2.3 The relationship between the efficiency of PLDD and severity of LDH: the less serious the disease is,the more effective the PLDD is.PID＜6mm,the efficiency can reach 90%.2.4 The relationship between the efficiency of PLDD and the course of diseases after the operation,the second day after the operation,the efficiency will reach 86%,more than 79%after one week,the disease will be stable after three months.2.5 complicationsPatients in the group are not applied antibiotics after the PLDD operation, no infected was found.Nd:the heat of YAG laser,especially when the whole power exceeds 1000J,there will be reactive and non-bacterial phlogosis in the disc tissue and pain in the waist.The rate of the complication is about 1%,and it rises with the increase of the laser's power.The complication will fade away after 3 to 5 days if the patients have a good rest and take the NSAID.2.6 There are no obvious differences of PLDD efficiency between the single-point and multi-point boiloff and decompression.
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