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激光的種類

激光的種類

  多種激光用于PLDD,主要使用的激光有:①Er:YAG激光,波長:2940nm。②CO2激光,10600nm。③Nd:YAG激光,波長:1064或1318nm。④Argon激光,波長488nm或514nm。⑤Ho:YAG激光,波長:2180nm。⑥準分子激光波長193nm。⑦KTP激光,532nm〔1〕。激光的選擇依賴于光纖的傳光能力:組織吸收/切除;熱量的產生和傳播。激光的特性特別重要,因為椎間盤無血管,是緊密組織并接近脊髓和神經組織〔4〕。在目前的實驗研究中,由于使用條件不一樣,各個激光系統汽化率不一樣,其中Choy〔1,2〕對此作了較為詳細的研究。他比較了多種不同激光波長對人尸椎間盤標本的汽化率,測得CO2,Er:YAG,Nd:YAG,Ho:YAG及Excimer的汽化率分別為0。23,0。20,0。16,0。13及0。08mg/J。雖然CO2和Er:YAG兩種不同波長的激光對椎間盤汽化效應最好,但目前無相應的傳播光纖,使其應用受到限制。Choy主張使用Nd:YAG進行PLDD為佳。新近使用的半導體激光(波長805nm),不但具有良好的汽化切割、凝固功能,而且其透射深度僅1mm,對周圍組織損傷甚微,從而使PLDD更加完美,幾乎無并發癥發生〔4,5〕。半導體激光優于CO2,Nd:YAG,KTP等激光。……

 


     

參考文獻:

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[10]Ohnmeiss DD,Guyer Rd,Hochschuler SH,et al.Laser disc decompression.The importance of proper patient selection.Spine.1994 Sep 15;19(18):2054-2059
[11]Steiner P,Zweifel K,Botnar R,et al.MR guidance of laser disc decompression:preliminary in vivo experience.Eur Radiol.1998;8(4):592-597
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[14]Cvitanic OA,Schimandle J,Casper GD,et al.subchondral marrow changes after laser diskectomy in the lumbar spine:MR imaging findings and clinical correlation.Am J Roentgenol.2000;174(5):1363-1369
[15]Epstein NE.Nerve root complications of percutaneous laser-assisted diskectomy performed at outside institutions:a technical note.J Spinal Disord 1994;7(6):510-512
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