Ke Kūlana o nā Nalu 980nm a me 1470nm i ka Percutaneous Laser Disc Decompression (PLDD)

Ka Hoʻokaʻawale ʻana o ka Disc Laser Percutaneous (PLDD)ua hoʻokumu iā ia iho ma ke ʻano he koho ʻokoʻa minimally invasive i ka ʻoki kino maʻamau no ka mālama ʻana i nā disc intervertebral herniated i loko. ʻO ke kumu nui o PLDD e pili ana i ka hoʻokomo ʻana o kahi fiber optical kūikawā i loko o ka nucleus disc, a ukali ʻia e ka lawe ʻana i ka ikehu laser e ablate i kahi liʻiliʻi o ka nucleus pulposus (NP). Hoʻokumu kēia vaporization i kahi lua intradiscal i kāohi ʻia, e hōʻemi ana i ke kaomi kūloko a ma hope e hoʻomaha i ka compression ma nā ʻano neural e pili ana. Ma waena o nā ʻōnaehana laser like ʻole i loaʻa, ua hōʻike nā lasers diode e hoʻopuka ana ma 980nm a me 1470nm i ka pono kūikawā ma muli o kā lākou mau ʻano absorption kūikawā i nā ʻiʻo olaola.

Hōʻike ka nalu 980nm i kahi coefficient absorption kaulike i ka wai a me ka hemoglobin. ʻAe kēia waiwai no ka coagulation like o nā kīʻaha intradiscal liʻiliʻi a me ka ablation thermal kūpono o ka NP. Eia nō naʻe, ua omo hapa ʻia ka ikehu 980nm e nā ʻiʻo i makemake ʻole ʻia, kahi e pono ai ke ʻano hana akahele e pale aku i ka hōʻino wela i ka cartilaginous endplate.

I ka hoʻohālikelike ʻana, kokoke ka nalu 1470nm i ka piko o ka omo ʻana o ka wai. No laila, ua omo ʻia kona ikehu e ka NP hydrated, e hōʻoiaʻiʻo ana i ka hopena wela i kaupalena ʻia. ʻOi aku ka kiʻekiʻe o ka pono o ka ablation o ka laser 1470nm—ma kahi o 20 a 30 mau manawa ʻoi aku ka nui ma mua o nā ʻōnaehana 1064nm Nd:YAG kahiko—e hiki ai ke hoʻolōʻihi i ka manawa hōʻike a hoʻemi i ka laha wela collateral i ka annulus fibrosus a me nā aʻalolo a puni. Hoʻouna pinepine ʻia nā nalu ʻelua ma o kahi Optical Fiber, kahi e kuhikuhi ai i ke kukuna i kahi ʻano puhi mua. He mea koʻikoʻi ka hoʻolālā Optical Fiber no PLDD, no ka mea e hiki ai i ke kauka ke kuhikuhi pololei i ka ʻāpana waena o ka NP me ka hoʻemi ʻana i ka pilikia o ka perforating i ka paia disc.

ʻO nā pono lapaʻau o ke ʻano 980nm/1470nm dual-wavelength e komo pū me ka hoʻemi koke ʻana o ke kaomi i loko o ka disc, ka hoʻōla wikiwiki ʻana ma hope o ke ʻoki ʻana, a me ka mālama ʻana i nā ʻāpana neʻe o ka iwi kuamoʻo. Hōʻike pinepine nā mea maʻi i ka hōʻoluʻolu nui o ka ʻeha radicular i loko o 24 a 48 mau hola. Haʻahaʻa ka helu pilikia ke alakaʻi ʻia nā kaʻina hana e ka fluoroscopy a kaupalena ʻia i nā herniations disc i hoʻopaʻa ʻia.

I ka hopena, ʻo ka synergy ma waena o ka nalu 980nm (vascular coagulation) a me ka nalu 1470nm (ka omo wai kiʻekiʻe) e hoʻolilo i ka ʻenehana laser diode i mea kūpono loa no PLDD. Hāʻawi kēia ʻano hana i kahi lāʻau palekana, kūpono no ka poʻe ma waho o ka haukapila no ka maʻi lumbar disc symptomatic, e hōʻemi pono ana i ka nui o ka NP me ka ʻole o ka hoʻopaʻa ʻana i ke kolamu kuamoʻo. Pono nā haʻawina hou aʻe e hoʻomaikaʻi i nā palena ikehu a me nā hoʻohālikelike hopena lōʻihi.