| Abstract [eng] |
The aim of this investigation is to apply laser light to investigate intervertebral disc material and to use laser light for treating intervertebral disc herniations. Our investigation consists of experimental part- spectroscopic study of intervertebral disc material; and clinical part- percutaneous laser disc decompression, introduction of the treatment method and case series analysis. Study analyses biochemical, structural and histological/histochemical changes of intervertebral disc, happening during degeneration process. We applied luminescence investigation of disc tissue auto fluorescence to investigate biochemical change in disc matrix. We created methodology for preparing and investigating intervertebral disc specimen. For the first time, we recorded disc auto fluorescence spectra, gathered by irradiation of disc material by UV laser. We compared collected spectra with histological/histochemical and biochemical changes in disc specimens. In clinical part of our study, for the first time in Lithuania, we performed laser surgery (PLDD) for intervertebral disc herniation. We collected group of the patients, evaluated indications and contraindication for the laser surgery, analyzed efficiency of the procedure. The results indicate that auto fluorescence refers to different substances constituting intervertebral disc. Spectral analysis can be used to determine biochemical changes in collagen types content of intervertebral disc matrix, and signs of disc degeneration can be identified indirectly. Spectroscopic investigation of degenerated disc according to the shape of spectra and spectroscopy may be a new very sensitive tool in determining different collagen types in different anatomical parts of intervertebral disc. Spectroscopic analysis of intervertebral disc removed during open surgery, creates background for further investigation on degenerating intervertebral disc spectral features and biochemical changes. Laser application can be used in treating intervertebral disc herniation. Patients having sequestration, transligamentous or extensive subligamentous extrusion are poor candidates for laser surgery and should go for open surgery; patients having moderate or mild protrusion of intervertebral disc without obvious compression of nerve roots are good candidates for laser surgery. |
