PDF(Pubmed)
Abstract：
UNASSIGNED: For the aging population, surgery for lumbar spinal canal stenosis (LSCS) requires minimally invasive procedures. Recently, trans-sacral epiduroscopic laser decompression for lumbar disc herniation has been reported with good results. In this study, we devised a new method to perform trans-sacral epiduroscopic laser ablation of the ligamentum flavum (LF), known to be the major cause of LSCS. Using a live pig, this study aims to evaluate the efficacy, safety, and drawbacks of this procedure.
UNASSIGNED: Using an epiduroscope, we observed intra-spinal canal structures and then examined the feasibility and problems of a decompression procedure to ablate the LF using holmium:YAG (Ho:YAG) laser. The pig was observed for behavioral changes and neurological deficits after the procedure. Histological analysis was performed to evaluate the amount of tissue ablation and damage to surrounding tissues.
UNASSIGNED: Although it was possible to partially ablate the LF using the Ho:YAG laser under epiduroscopy, it was difficult to maintain a clear field of view, and freely decompressing the target lesion has been a challenge. After the first two experiments, the pig neither showed abnormal behavior nor any signs of pain or paresis. However, in the third experiment, the pig died during the operation. On autopsy, no thermal or mechanical injury was noted around the ablated site, including the dura mater and nerve root. Histological analysis showed that the LF and lamina were deeply ablated as the laser power increased, and no damage was noted on surrounding tissues beyond a depth of 500 μm.
UNASSIGNED: Although Ho:YAG laser could ablate the ligamentum and bone tissues without causing damage to surrounding tissues, it was difficult to completely decompress the LF under epiduroscopy. This method is a potentially highly invasive procedure that requires caution in its clinical application and needs further improvement in terms of the instruments and techniques used.
UNASSIGNED: Using an epiduroscope, we observed intra-spinal canal structures and then examined the feasibility and problems of a decompression procedure to ablate the LF using holmium:YAG (Ho:YAG) laser. The pig was observed for behavioral changes and neurological deficits after the procedure. Histological analysis was performed to evaluate the amount of tissue ablation and damage to surrounding tissues.
UNASSIGNED: Although it was possible to partially ablate the LF using the Ho:YAG laser under epiduroscopy, it was difficult to maintain a clear field of view, and freely decompressing the target lesion has been a challenge. After the first two experiments, the pig neither showed abnormal behavior nor any signs of pain or paresis. However, in the third experiment, the pig died during the operation. On autopsy, no thermal or mechanical injury was noted around the ablated site, including the dura mater and nerve root. Histological analysis showed that the LF and lamina were deeply ablated as the laser power increased, and no damage was noted on surrounding tissues beyond a depth of 500 μm.
UNASSIGNED: Although Ho:YAG laser could ablate the ligamentum and bone tissues without causing damage to surrounding tissues, it was difficult to completely decompress the LF under epiduroscopy. This method is a potentially highly invasive procedure that requires caution in its clinical application and needs further improvement in terms of the instruments and techniques used.
摘要：
未经批准：对于人口老龄化，腰椎管狭窄症（LSCS）的手术需要微创手术。最近,经骶骨上皮镜激光减压术治疗腰椎间盘突出症疗效良好。在这项研究中,我们设计了一种新的方法来进行经骶骨内镜下激光消融黄韧带（LF），已知是LSCS的主要原因。用一头活猪，这项研究旨在评估疗效，安全,和这个程序的缺点。
UNASSIGNED：使用内窥镜，我们观察了椎管内结构，然后检查了使用钬：YAG（Ho：YAG）激光消融LF的减压手术的可行性和问题。手术后观察猪的行为变化和神经功能缺损。进行组织学分析以评估组织消融的量和对周围组织的损伤。
UNASSIGNED：尽管可以在内窥镜下使用Ho:YAG激光部分消融LF，很难保持清晰的视野，和自由减压靶病变一直是一个挑战。在前两个实验之后,猪既没有表现出异常行为，也没有任何疼痛或轻瘫的迹象。然而,在第三个实验中，猪在手术中死亡。尸检时,消融部位周围未发现热损伤或机械损伤，包括硬脑膜和神经根.组织学分析表明，随着激光功率的增加，LF和薄层被深度烧蚀，并且在超过500μm的深度的周围组织上没有发现损伤。
未经证实：尽管Ho:YAG激光可以消融韧带和骨组织，而不会对周围组织造成损害，在膀胱镜检查下很难完全减压。这种方法是一种潜在的高侵入性手术，在临床应用中需要谨慎，并且在使用的仪器和技术方面需要进一步改进。
UNASSIGNED：使用内窥镜，我们观察了椎管内结构，然后检查了使用钬：YAG（Ho：YAG）激光消融LF的减压手术的可行性和问题。手术后观察猪的行为变化和神经功能缺损。进行组织学分析以评估组织消融的量和对周围组织的损伤。
UNASSIGNED：尽管可以在内窥镜下使用Ho:YAG激光部分消融LF，很难保持清晰的视野，和自由减压靶病变一直是一个挑战。在前两个实验之后,猪既没有表现出异常行为，也没有任何疼痛或轻瘫的迹象。然而,在第三个实验中，猪在手术中死亡。尸检时,消融部位周围未发现热损伤或机械损伤，包括硬脑膜和神经根.组织学分析表明，随着激光功率的增加，LF和薄层被深度烧蚀，并且在超过500μm的深度的周围组织上没有发现损伤。
未经证实：尽管Ho:YAG激光可以消融韧带和骨组织，而不会对周围组织造成损害，在膀胱镜检查下很难完全减压。这种方法是一种潜在的高侵入性手术，在临床应用中需要谨慎，并且在使用的仪器和技术方面需要进一步改进。
