Columnar dodging laser fiber

Abstract

The invention discloses a columnar dodging laser optical fiber, the optical fiber sequentially comprises a fiber core, a cladding layer and a sleeve layer from inside to outside, the fiber core is sleeved in the cladding layer, the outer surface of the optical fiber is coated with the sleeve layer, and N sections of scattering monomers or N scattering refraction points are sequentially arranged at the tail end of the fiber core along the length direction of the fiber core according to the design requirement of the luminous length of columnar light, a scattering continuum is formed by filling scatterer particles in each scattering single body or continuously writing and arranging refraction points, and a wrapping layer sleeved with a fiber core is in butt joint with the scattering continuum, so that lateral columnar uniform light transmission of the laser treatment optical fiber is intensively realized in a target set distance range in the length direction. The laser optical fiber can be used for spinal nerve injury treatment including diseases such as protrusion of intervertebral disc, spinal canal stenosis, spondylolisthesis or traumatic fracture of each section of cervical vertebra, thoracic vertebra, lumbar vertebra and sacral vertebra.

Description

Technical Field

[0001] The invention belongs to the field of medical devices, and in particular relates to a columnar uniform light laser optical fiber for treating spinal nerve injuries. Background Art

[0002] Spinal cord injury (SCI) is a damage to the structure and function of the spinal cord caused by various injury factors, resulting in functional disorders (movement, sensation, reflex, etc.) below the injury level. It has the characteristics of high disability rate and poor prognosis, making SCI one of the main diseases that endanger the health of the people.

[0003] There are many reasons for spinal nerve injury, including degenerative diseases, such as cervical spinal stenosis, thoracic spinal stenosis and lumbar disc herniation. There are also traumatic spinal nerve injuries, the most common of which are various high-energy impact injuries, such as falling from heights and car accidents. In addition, spinal deformities, spinal infections and spinal tumors may all cause spinal nerve injuries to varying degrees.

[0004] The therapeutic effect of spinal nerve injury depends on the type and severity of the injury itself. According to the pathology after spinal nerve injury, it can be divided into primary spinal nerve injury and secondary spinal nerve injury. Primary injury is directly caused by a variety of diseases such as vertebral fracture displacement, spinal canal stenosis and intervertebral disc herniation. Primary injury triggers a series of downstream cellular reactions (microcirculatory disorders, inflammatory infiltration, neuronal apoptosis, etc.), leading to secondary spinal cord injury. Secondary spinal nerve injury refers to various adverse events that occur over time after primary injury. From early bleeding, edema, and acute inflammatory reactions to mid-term microcirculatory disorders, calcium ion influx, free radical formation, and even later secondary ischemia and hypoxia, nerve demyelination, and glial scar formation, they may occur alone or simultaneously. Therefore, the development of a therapeutic optical fiber that can cover different patients, different types of diseases, and different inflammations or pathological changes has a broader market value.

[0005] In spinal nerve injury, surgery is still the main way to treat this type of disease. Trauma and degeneration are the two major causes of surgery, among which cervical spondylosis, lumbar disc herniation, and compression fractures are the types of diseases with a relatively high proportion of surgery. In the past forty years, although surgical techniques have made great progress, the existing treatment options after central nervous system injury still continue the past experience, removing compression factors such as fracture fragments and spinal canal stenosis through surgery, and the recovery of spinal nerve damage mainly relies on drugs, acupuncture, physical therapy, and massage, and its efficacy is not satisfactory. Medical workers have also tried a variety of methods including hormone shock, anti-inflammatory drugs, nerve nutrition, nerve cell transplantation, and tissue engineering material placement for repair treatment, but there is currently no reliable and effective treatment method that can fully restore the function of patients with spinal nerve injury. This is also one of the reasons for the increase in doctor-patient conflicts in this type of disease at this stage. Medical staff and patients are eager to have a rehabilitation method that directly targets the damaged spinal cord to effectively speed up and improve the degree of spinal cord recovery. Therefore, repair after central nervous system injury is still a major challenge in the field of rehabilitation medicine.

[0006] Weak laser has been used in clinical scientific research by relevant researchers because of its non-invasive characteristics, including anti-inflammatory, analgesic, promotion of injury repair and other photochemical, biological stimulation, and thermal therapy effects. For example, percutaneous irradiation or intravascular irradiation technology, which is still in the research stage, has revealed some technical risks in clinical research. Percutaneous irradiation technology can easily make it difficult for light to reach the surface of the spinal cord, affecting the absorption of spinal cord tissue and limiting the biological regulation of light. Intravascular irradiation technology, because the irradiation components will be placed inside the blood vessels, it is easy to increase the risk of postoperative infection and bloodstream infection.

[0007] Most organs and tissues in the human body are cell stacks, and the loss or apoptosis of a small number of cells has no effect on the function of the organ or tissue. The spinal cord and other nerves are cell-connected tissues. The loss and apoptosis of a single nerve cell can cause the interruption of upstream and downstream electrical signal transmission, resulting in serious functional impairment and changes. As an important carrier of life information transmission, each cell of the spinal nerve has the same repair demand for light. The repair and improvement of a single cell is crucial to the overall repair of spinal nerve connections. Therefore, higher clinical requirements are placed on the uniformity and reliability of laser irradiation. In addition, in different cases, the length of the injured segment of the spinal nerve varies. The shorter ones generally only involve one vertebral segment, and the longer ones may involve 4 or more vertebral lengths. For damaged areas of different lengths, higher requirements are also placed on the uniformity of the optical fiber.

[0008] Existing treatment optical fibers generally have two major parts: a high-refractive-index optical fiber core and a low-refractive-index optical scattering cladding. Some dispersants are also uniformly doped in the optical scattering cladding to destroy the reflective interface between the optical fiber core and the cladding. When the incident light encounters these dispersants on the reflective interface, it will be transmitted from the inside of the optical fiber core. However, conventional technologies have various defects. For example, weak lasers are easily focused in a small area, which not only causes large light transmission losses, but also weak and uneven light output intensity throughout the body. The light output intensity cannot be stably and reliably controlled, and it is impossible to ensure that the laser fiber can achieve uniform light output laterally at a specific length (treatment area). Therefore, it is necessary to develop a weak laser uniform light fiber whose light-emitting treatment area can meet the needs of different patients, different types of spinal nerve injury diseases, different inflammations and pathological treatments, and ensure that the target length is uniformly illuminated along the axis on the premise of carrying different laser power outputs, and the uniform light intensity can be adaptively adjusted.

[0009] In order to solve the above technical problems, there are two main methods for the existing fiber optical mode field homogenization and shaping to achieve the beam homogenization and shaping of the fiber structure: 1) directly homogenize the energy distribution of the fundamental mode Gaussian beam, transfer part of the energy in the center of the beam to the edge of the beam to obtain a fundamental mode output with a flat energy distribution, and finally achieve the purpose of homogenizing the beam energy; 2) increase the proportion of high-order modes in the output laser to enhance the energy at the edge of the fundamental mode, and finally achieve multi-mode output and thus achieve uniform energy distribution of the output light spot.

[0010] However, the above-mentioned existing fiber homogenization methods are all used to achieve uniform energy distribution of the output light spot at the fiber end face, and cannot effectively ensure that the optical fiber is within a specific target length range, especially along the side of the central axis to uniformly emit light to form a "columnar" stable and uniform light, thereby meeting the treatment needs of spinal nerve injuries. Summary of the invention

[0011] In view of the defects or technical problems existing in the prior art, the present invention aims to provide a columnar uniform light laser fiber. The fiber has a wide transmission spectrum range and low light transmission loss under the premise of a long light emission distance, and can also achieve a specific target length range, and the fiber transmits uniformly and efficiently along the axial direction.

[0012] In order to solve the above technical problems, the present invention adopts the following technical solutions: A columnar uniform light laser optical fiber, the optical fiber comprises a core, a cladding and a sleeve from the inside to the outside, the core is sleeved in the cladding, the outer surface of the optical fiber is covered with the sleeve, at the end of the core, according to the design requirements of the columnar light emitting length, N sections of scattering monomers or N scattering inflection points are arranged in sequence along the length direction of the core, a scattering continuum is formed by filling scatterer particles in each scattering monomer or continuously writing and arranging inflection points, the cladding sleeved on the core is connected to the scattering continuum, thereby realizing lateral columnar uniform light transmission of the laser treatment optical fiber along the length direction within a target set distance range.

[0013] Furthermore, one of the optical fiber structures of the present invention is a scattering monomer filling structure. If scatterer particles are filled in each scattering monomer, different numbers of scatterer particles should be evenly filled in the scattering monomer matrix according to the distance between the longitudinal boundary of each scattering monomer and the end of the fiber core, thereby forming a discontinuous and irregular scatterer particle filling distribution in the scattering continuum. A sheath layer is coated on the outer surface of the optical fiber, so that the laser treatment optical fiber can realize lateral columnar uniform light transmission within the target set distance range along the length direction.

[0014] Furthermore, another optical fiber structure of the present invention, namely the scattering inflection point structure, if the inflection points are arranged continuously, the inflection points should be non-uniformly and continuously written in the scattering continuum through a femtosecond laser system according to the distance of each inflection point from the end of the fiber core, so that the laser treatment optical fiber can realize lateral columnar uniform light transmission within the target set distance range along the length direction.

[0015] Furthermore, the overall structure of the optical fiber of the present invention can also be provided with a total reflection cylindrical mirror at the end of the scattering continuum, and the cladding of the sleeved fiber core is connected to the scattering continuum to form an optical fiber together with the total reflection cylindrical mirror, and the outer surface of the optical fiber is coated with a sleeve layer.

[0016] A coating layer is also coated on the outside of the scattering continuum, and the refractive index of the coating layer is required to be lower than the refractive index of the scattering monomer matrix.

[0017] In one type of scattering monomer-filled optical fiber, the relative refractive index difference between the fiber core and the scattering monomer matrix is ​​less than or equal to 0.15, the reflectivity of light on the interface between the fiber core and the scattering monomer is less than 5%; the relative refractive index difference between the scattering monomer matrix and the scatterer particles is 0.1-0.5; and the refractive index of the coating layer is lower than the refractive index of the scattering monomer matrix.

[0018] Another type of scattering inflection point structure optical fiber has a core refractive index of 1.41, an inflection point refractive index of 1.43±1%, an inflection point diameter of 50μm±5μm, a fs laser power of a femtosecond laser system of 50-100μJ, and a fs laser repetition rate of 10-100KHz.

[0019] In the scattering monomer filling structure of the present invention, the columnar light emission length is determined according to the application scenario. The columnar light emission length divided by the number of scattering monomers N can be used to obtain the length of the scattering monomer. The unit length of the scattering monomer determines the peak-to-valley fluctuation of the side luminous intensity of the columnar light-emitting area. According to the distance x from the longitudinal boundary of each scattering monomer to the end of the fiber core, different numbers of scatterer particles are uniformly filled in the scattering monomer substrate, and the number of scatterer particles filled with different numbers y is filled and arranged according to a certain distribution law. The diameter of the scatterer particles is between one and eight times the wavelength of the incident light.

[0020] Furthermore, the core of the columnar homogenous laser optical fiber of the present invention is low-hydroxyl pure quartz glass, the cladding is fluorine-containing acrylic resin, and the jacket is epoxy resin and / or silica gel.

[0021] Furthermore, in one of the scattering inflection point structures of the present invention, inflection points are non-uniformly and continuously written in a scattering continuum by a femtosecond laser system, and the distribution change rule of the inflection points is:

[0022] in Indicates the serial number of the inflection point; z indicates the distance from the corresponding inflection point to the starting inflection point 0 The distance between them, unit: mm; where: A=0.83265±0.08307, B=1.30798±0.00894, C=-0.01167±0.0002; the maximum value of w is a positive integer in the interval [38, 49].

[0023] The columnar uniform light laser optical fiber of the present invention does not emit light from the laser light source to the end of the fiber core, and the optical power density of the columnar uniform light generated between the end of the fiber core and the tail of the scattering continuum is 20mW / cm 2 -730mW / cm 2 The uniformity of the light power density distribution of the columnar uniform light is 9%-15%.

[0024] The columnar light-homogenizing laser optical fiber of the present invention can be used for the treatment of spinal nerve injury, and is suitable for the treatment of intervertebral disc herniation, spinal stenosis, spondylolisthesis or traumatic fracture diseases in various segments of the cervical, thoracic, lumbar and sacral vertebrae.

[0025] Compared with the prior art, the present invention has the following technical advantages: 1. The columnar uniform light laser fiber of the present invention realizes uniform light emission in all directions along the axis of the light-emitting treatment area, thus laying a solid foundation for meeting the individualized treatment and rehabilitation needs of patients with different disease severity.

[0026] 2. The columnar homogenous laser fiber of the present invention can adjust the homogenous light power density according to the treatment target requirements of clinical diseases and the size of the treatment target area, and ensure the stability and reliability of the homogenous light emission. It is more suitable for the treatment and repair of spinal nerve tissue injuries in deeper locations.

[0027] 3. The columnar homogenous laser fiber of the present invention realizes the control of the rate and efficiency of weak laser side scattering leakage by adjusting the distribution of the refractive index of the fiber scattering continuum, thereby meeting the clinical requirements for the treatment and repair of spinal nerve tissue damage in a specific target area. BRIEF DESCRIPTION OF THE DRAWINGS

[0028] Figure 1a It is a schematic diagram of an overall optical fiber structure (scattering monomer filling type) of the present invention.

[0029] Figure 1b It is a schematic diagram of another optical fiber overall structure (scattering inflection point type) of the present invention.

[0030] Figure 2a It is a partial enlarged schematic diagram of the optical fiber of the overall optical fiber structure (scattering monomer filling type) of the present invention.

[0031] Figure 2b It is a schematic diagram of a partial magnification of the optical fiber of the present invention's overall structure (scattering inflection point type).

[0032] Figure 3a It is a partially enlarged schematic diagram of another structure of the optical fiber (scattering monomer filled type) of the present invention.

[0033] Figure 3b It is a partially enlarged schematic diagram of another structure of the optical fiber (scattering inflection point type) of the present invention.

[0034] Figure 4a This is a schematic diagram of the optical fiber (scattering monomer filled) effect verification test of the present invention.

[0035] Figure 4b This is a schematic diagram of the optical fiber (scattering inflection point type) effect verification test of the present invention.

[0036] Figure 5a It is a schematic diagram of the light tracing effect of the optical fiber (scattering monomer filled type) of the present invention.

[0037] Figure 5b It is a schematic diagram of the optical fiber (scattering inflection point type) ray tracing effect of the present invention.

[0038] Fig.6a1 This is a light intensity distribution diagram of the optical fiber (scattering monomer filled type) core end of the present invention; Fig.6a2 The light intensity distribution diagram of the end of the scattering continuum of the optical fiber (scattering monomer filled type) of the present invention; Figure 6b1This is the light intensity distribution diagram of the optical fiber (scattering inflection point type) core end of the present invention; Figure 6b2 The light intensity distribution diagram at the end of the scattering continuum of the optical fiber (scattering inflection point type) of the present invention.

[0039] Figure 7a It is the lateral light intensity distribution diagram of the scattering continuum of the optical fiber (scattering monomer filled type) of the present invention; Figure 7b This is the lateral light intensity distribution diagram of the scattering continuum of the optical fiber (scattering inflection point type) of the present invention.

[0040] Figure 8a It is a distribution diagram of the lateral luminous intensity at different positions of the scattering continuum of the optical fiber (scattering monomer filled type) of the present invention.

[0041] Figure 8b It is a distribution diagram of the lateral luminous intensity at different positions of the scattering continuum of the optical fiber (scattering inflection point type) of the present invention.

[0042] Figure 9a It is the relationship between the position of the scattering monomers and the number of filled scattering particles of the optical fiber (scattering monomer filled type) of the present invention, and the lateral light intensity distribution diagram at different positions of the corresponding scattering continuum.

[0043] Figure 9b This is a lateral luminous intensity distribution diagram corresponding to the position distribution of the inflection point of the optical fiber (scattering inflection point type) of the present invention.

[0044] Fig.10 This is the luminous intensity distribution diagram of traditional diffuse optical fiber.

[0045] Fig.11 This is the lateral light intensity distribution diagram of traditional diffuse optical fiber. DETAILED DESCRIPTION

[0046] The specific content and mechanism of the present invention are further described in detail below in conjunction with the accompanying drawings and specific implementation methods. It should be noted that structures that are equivalent to the same technical concept of the present invention all fall within the scope of protection claimed by the present invention.

[0047] See also Figure 1a , Figure 1b Schematic diagram of two types of columnar light-homogenizing laser optical fiber structures of the same technical concept of the present invention, one structure is referred to as a scattering monomer filling structure, such as Figure 1a Another structure is referred to as the scattering inflection point structure, such as Figure 1b .

[0048] See also Figure 1a , Figure 2aThe columnar homogenous laser optical fiber of the present invention comprises a core 1, a cladding 2 and a sleeve 5 from the inside to the outside. The core 1 is sleeved in the cladding 2. At the end of the core 1, according to the design requirements of the columnar light emission length, N scattering monomers 3 or N scattering inflection points 9 are sequentially arranged along the length direction of the core. A scattering continuum 4 is formed by filling scattering particles 7 in each scattering monomer 3 or continuously writing and arranging the inflection points 9. The cladding 2 sleeved with the core 1 is butted with the scattering continuum 4, so that the laser treatment optical fiber can realize the lateral columnar homogenous light transmission in the target set distance range along the length direction.

[0049] One of the optical fiber structures of the present invention is a scattering monomer filled structure. If scattering particles 7 are filled in each scattering monomer 3, different numbers of scattering particles 7 are uniformly filled in the scattering monomer 3 matrix according to the difference in distance between the longitudinal boundary of each scattering monomer 3 and the end of the fiber core 1, thereby forming a discontinuous and irregular scattering particle filling distribution in the scattering continuum 4.

[0050] See also Figure 3a A total reflection cylindrical mirror can also be provided at the end of the scattering continuum 4. The cladding 2 of the sleeved fiber core 1 is connected to the scattering continuum 4, and is drawn together with the total reflection cylindrical mirror 8 through a rod-tube drawing furnace to form an optical fiber. A sleeve layer 5 is coated on the outer surface of the optical fiber, so that the laser treatment optical fiber can realize lateral columnar uniform light transmission within the target set distance range along the length direction.

[0051] Specifically, the fiber core 1 of the present invention is low-hydroxy pure quartz glass, the cladding 2 is fluorine-containing acrylic resin, and the jacket 5 is epoxy resin and / or silica gel to ensure its flexibility and biocompatibility. The fiber core 1 is low-hydroxy pure quartz glass with a refractive index of 1.4532.

[0052] According to the specific requirements of the application, a side emitting area is set at the end of the fiber core to achieve uniform and efficient leakage of light energy from the side within a fixed length. The scattering monomer at the end of the fiber core contains an optically transparent continuous phase and a dispersed phase with a different refractive index from the continuous phase. The continuous phase is used for axial transmission of light, and the dispersed phase is used to scatter the light and then emit it from the side.

[0053] The length of the columnar light is determined according to the application scenario. The unit length of the scattering monomer can be obtained by dividing the columnar light length by the number of scattering monomers N. The length of the scattering monomer determines the peak-to-valley fluctuation of the side luminous intensity of the columnar light-emitting area. Within the same columnar light-emitting length, the larger the number of scattering monomers N, the smaller the unit length of the scattering monomers, and it is easier to achieve smaller peak-to-valley fluctuations in light intensity.

[0054] The outer side of the scattering continuum 4 is also coated with a coating layer 6. In order to maintain the stable transmission of light inside the scattering body and reduce the interference of the external environment, the refractive index of the coating layer 6 is required to be lower than the refractive index of the scattering body continuous phase (scattering monomer 3 matrix). The optional materials include PDMS, acrylic resin, etc.

[0055] The relative refractive index difference between the core 1 and the scattering monomer 3 matrix is ​​as close as possible, the smaller the better, the main purpose is to reduce the reflection of the optical fiber at the interface between the two. The greater the refractive index difference, the higher the reflectivity, which will cause the light energy to be returned to the optical fiber, and even returned to the laser light source. The relative refractive index difference between the core 1 and the scattering monomer 3 matrix is ​​less than or equal to 0.15, and the reflectivity of the light at the interface between the core 1 and the scattering body monomer 3 is less than 5%. The relative refractive index difference between the scattering monomer 3 matrix and the scattering body particles 7 is 0.1-0.5.

[0056] See also Figure 4a , Figure 9a , according to the distance x (unit: mm) from the longitudinal boundary of each scattering monomer 3 to the end of the fiber core 1, different numbers of scattering particles 7 are uniformly filled in the scattering monomer 3 matrix; the basis for filling different numbers y (unit: pieces) of scattering particles 7 is:

[0057] Among them: A=24674.42±5527.51, B=2781.64±848.73, C=-343.78±164.75, D=13.02±10.21, E=-0.013±0.179.

[0058] In the present invention, the diameter of the scattering particles 7 is set to be between one and eight times the wavelength of the incident light in combination with the scattering principle. To obtain the best scattering effect, the size of the scattering body is preferably one wavelength.

[0059] See also Figure 1b , Figure 2b , which is another structural scattering inflection point structure of the same technical concept of the present invention. If the inflection points 9 are arranged continuously, the inflection points 9 should be written continuously and non-uniformly in the scattering continuum 4 through the femtosecond laser system according to the distance of each inflection point 9 from the end of the fiber core, so that the laser treatment optical fiber can realize lateral columnar uniform light transmission within the target set distance range along the length direction.

[0060] See also Figure 3b The end of the scattering continuum 4 is also provided with a total reflection cylindrical mirror 8, the cladding 2 of the sleeved fiber core 1 is butted with the scattering continuum 4, and together with the total reflection cylindrical mirror 8, an optical fiber is formed, and a sleeve layer 5 is coated on the outer surface of the optical fiber. Figure 2bThe refractive index of the fiber core 1 is 1.41, the refractive index of the inflection point 9 is 1.43±1%, the inflection point diameter is 50μm±5μm, the fs laser power of the femtosecond laser system is: 50-100μJ, and the fs laser repetition rate is: 10-100KHz.

[0061] See also Figure 9b , the distribution change rule of inflection point 9 is:

[0062] in Indicates the serial number of the inflection point; z indicates the distance from the corresponding inflection point to the starting inflection point 0 The distance between them, unit: mm; where: A=0.83265±0.08307, B=1.30798±0.00894, C=-0.01167±0.0002; the maximum value of w is a positive integer in the interval [38, 49].

[0063] See also Figure 4a , Figures 4b to 8a , Figure 8b The two optical fiber structures of the same concept of the present invention were tested for their uniform light effects. The optical fiber structure of the present invention can achieve non-luminescence from the laser light source to the end of the fiber core 1, effectively reducing the transmission energy loss. At the same time, it can quickly and stably meet the treatment light intensity requirements in the target area of ​​luminous treatment, and can evenly and continuously emit light around the axis to form a "columnar" light body.

[0064] In comparison, under the same conditions, see Figure 10-11 The luminous intensity rendering of traditional diffuse optical fiber. Traditional diffuse optical fiber needs to undergo a certain distance of optical fiber transmission from the starting end of the light emission to achieve the required therapeutic light intensity. As the optical fiber is extended, the light intensity gradually decays, and the optical fiber transmission efficiency decreases, making it impossible to achieve uniform light intensity output and unable to accurately cover the target treatment area.

[0065] Embodiment: The columnar uniform light laser fiber of the present invention is specifically applied in the clinical treatment and repair of spinal nerve injury. First, the length of the columnar light "light column" should be set and selected according to the location of the spinal nerve injury. Secondly, the light irradiation energy parameters are set in combination with the treatment needs of clinical diseases. Thirdly, the columnar uniform light laser fiber is placed on the spinal cord exposed by surgery in patients with spinal nerve injury.

[0066] The two equivalent columnar homogenous laser fibers of the present invention were tested for their functions. The fiber did not emit light in the circumferential direction from the laser light source to the end of the fiber core 1, and the optical power density of the columnar homogenous light generated between the end of the fiber core and the tail of the scattering continuum was 20 mW / cm 2 -730mW / cm 2The spot rate density distribution uniformity of the columnar uniform light can reach 9%-15%, which fully meets the industry standard requirements of medical laser fiber.

[0067] The columnar light-homogenizing laser optical fiber of the present invention can be used for treating spinal nerve injuries.

[0068] Clinical studies have found that the uniformity of laser irradiation is crucial to the overall repair of spinal nerve connections. Through the subdivision and mechanism research of different causes of spinal nerve injury, it is found that the columnar uniform light laser fiber of the present invention has effectively improved the clinical treatment effect in the treatment and repair of intervertebral disc herniation, spinal stenosis, spondylolisthesis and traumatic fractures in various segments of the cervical, thoracic, lumbar and sacral vertebrae. The specific performance is as follows: The columnar uniform light laser fiber of the present invention can treat mild lumbar disc herniation (the clinical manifestation of the symptom: only pain and numbness, no muscle weakness), and the irradiation treatment parameters are selected as follows: the irradiation wavelength is 808nm, the irradiation power is 300mW, and the irradiation is continuous for 0.5-1 hour every day for 7-10 days after surgery. Therapeutic mechanism: through uniform light irradiation, the abnormal upregulation of multiple pain-related sodium ion channels on the membrane of spinal neurons and dorsal root ganglion cells after nerve injury is reduced. The sodium ion channel is a voltage-gated channel of a transmembrane protein. Through uniform light irradiation, the entry of sodium ions into the cell is reduced, thereby inhibiting the generation and development of neuralgia. 2) The columnar uniform light laser fiber of the present invention treats severe lumbar disc herniation (the clinical manifestation of the symptom: pain and numbness, accompanied by muscle weakness), and the irradiation treatment parameters are selected as follows: the irradiation wavelength is 808nm, the irradiation power is 500mW, and the irradiation is continuous for 0.5-1 hour every day for 7-10 days after surgery. Treatment mechanism: Uniform light illumination changes macrophage polarization to inhibit astrocyte activation and secretion, allowing macrophages to be more in the M2 activation state rather than the M1 activation state, inhibiting the expression of astrocyte marker glial fibrillary acid protein (GFAP) and the secretion of chondroitin sulfate proteoglycan (CSPG), reducing the number of M1 macrophages in the body. During photobiomodulation therapy, uniform light illumination is more conducive to regulating the interaction between macrophages and astrocytes after spinal nerve injury, thereby inhibiting the formation of glial scars and promoting self-repair of neural tissue.

[0069] 3) The cylindrical homogenized laser fiber of the present invention is used to treat mild lumbar spinal stenosis (the clinical manifestation of the symptom: only pain and numbness, no muscle weakness). The irradiation treatment parameters are selected as follows: the irradiation wavelength is 808nm, the irradiation power is 400mW, and the irradiation is continuous for 0.5-1 hours per day for 7-10 days after surgery. Therapeutic mechanism: The uniform light irradiation can reduce the accumulation of inflammatory cells at the site of injury, reduce autoinflammatory damage, and promote nerve regeneration. Photobiomodulation therapy can promote the recovery of motor function, inhibit the activation of neurotoxic microglia and astrocytes, reduce neuroinflammation and tissue apoptosis, and increase the number of neurons retained after SCI. Photobiomodulation therapy can inhibit the upregulation of lipocalin 2 (Lcn2) and the activation of the Janus kinase 2-signal transducer and activator of transcription 3 (JAK2-STAT3) pathway after SCI.

[0070] 4) The cylindrical homogenized laser fiber of the present invention is used to treat severe cervical spinal stenosis (the clinical manifestations of this symptom: not only pain and numbness in the upper limbs, but also accompanied by decreased muscle strength in the upper and lower limbs, high muscle tension, and active tendon reflexes). The irradiation treatment parameter selection is: irradiation wavelength 808nm, irradiation power 500mW, and irradiation for 7-10 days after surgery for 0.5-1 hour per day. Therapeutic mechanism: The increase of interleukin-10 (IL-10) in the local area of ​​nerve injury can be increased by homogenized light irradiation, and IL-10 can inhibit the overexpressed autoimmune inflammatory response, thereby reducing nerve damage, promoting nerve regeneration, and promoting the recovery of motor function in the later stage of injury. Although IL-10 begins to express in the early stage of SCI, its expression level is low and the expression speed is slow. It increases to the peak value 5 days after injury. The expression speed and expression level of IL-1O are significantly increased after weak laser irradiation. It can be considered that the increase in IL-1O expression in damaged tissue after weak laser irradiation can not only antagonize the secondary inflammatory response caused by proinflammatory factors, which is beneficial to improving the injured microenvironment, but also play a direct neuroprotective role through the upregulation of IL-1O expression, thereby increasing the number of surviving neurons and facilitating the recovery of motor function in the later stage of spinal nerve injury. This is the molecular mechanism by which weak laser uniform light irradiation promotes the repair of spinal nerve injury.

[0071] 5) The cylindrical homogenized laser fiber of the present invention is used to treat mild cervical spondylolisthesis (the clinical manifestations of the symptoms are: only neck pain, mild pain and numbness in both upper limbs, and no muscle weakness). The irradiation treatment parameters are selected as follows: irradiation wavelength 808nm, irradiation power 300mW, irradiation for 7-14 days after surgery, daily pulsed irradiation for 1-2 hours, and pulse scheme of 10Hz. Therapeutic mechanism: uniform light irradiation promotes the growth of new nerve fibers, reduces the formation of scars after nerve injury, and ultimately reduces the formation of cavities after spinal nerve injury. Photobiomodulation therapy reduces the range of spinal cord cavities, reduces glial scars in the injured area, and reduces the expression of chondroitin sulfate proteoglycans (CSPGs), thereby reducing secondary injuries and facilitating the regeneration of nerve axons and functional recovery.

[0072] 6) The cylindrical homogenized laser fiber of the present invention is used to treat severe lumbar spondylolisthesis (the clinical manifestations of this symptom: not only pain and numbness, but also muscle weakness and intermittent claudication), and the irradiation treatment parameters are selected as follows: irradiation wavelength 808nm, irradiation power 500mW, irradiation for 7-14 days after surgery, daily pulsed irradiation for 1-2 hours, and pulse scheme of 30Hz. Therapeutic mechanism: By extending the homogenized light irradiation time, the stability of the blood-spinal cord barrier is maintained, the damaged blood-spinal cord barrier is repaired, and the local infiltration and destruction of inflammatory cells caused by damage to the blood-spinal cord barrier is reduced. Once the damage occurs, the blood-spinal barrier is destroyed, the neurons undergo oxidative stress, necroptosis occurs, and a large number of inflammatory cells gather, causing further damage; macrophages are the main inflammatory cells involved in this process. Photobiomodulation therapy can promote the survival and axon regeneration of dorsal root ganglia under SCI oxidative stress, increase the CCL2 secretion level of dorsal root ganglia, and this change can reduce the polarization of macrophages to M1, further indicating that photobiomodulation therapy can promote the repair of spinal nerve injury.

[0073] 7) The cylindrical homogenized laser fiber of the present invention is used to treat mild thoracic spinal stenosis (the clinical manifestations of the symptoms are mild pain and numbness in both lower limbs). The irradiation treatment parameters are: irradiation wavelength 808nm, irradiation power 400mW, irradiation for 7-14 days after surgery, daily pulsed irradiation for 1-2 hours, and pulse scheme of 20Hz. Therapeutic mechanism: uniform light irradiation promotes the differentiation of neural stem cells and other stem cells with directional differentiation function into neuronal cells, and replenishes damaged or apoptotic nerve cells. Photobiomodulation therapy can increase the permeability of nerve cell membranes, thereby changing the Ca 2+ The permeability of Ca 2+ It can affect the growth of neurites and the migration of growth cones, enhance the nerve growth factor's effect in promoting nerve regeneration, and thus promote nerve regeneration and repair.

[0074] 8) The cylindrical homogenized laser fiber of the present invention is used to treat severe thoracic spinal stenosis (the clinical manifestations of the symptoms are: hypoesthesia and numbness of the trunk and lower limbs, significantly increased muscle tension of the lower limbs, hyperreflexia of the tendons, and positive pathological signs). The irradiation treatment parameter selection is: irradiation wavelength 808nm, irradiation power 400mW, irradiation for 7-14 days after surgery, daily pulsed irradiation for 1-2 hours, and the pulse scheme is 10Hz. Therapeutic mechanism: Improve the microcirculation around the spinal nerves through homogenized light irradiation, increase the blood flow of microvessels, and reduce local peroxide and oxidative stress damage.

[0075] 9) The cylindrical homogenized laser fiber of the present invention is used to treat cervical vertebral fracture and dislocation (the clinical manifestations of this symptom: the sensation and muscle strength of the trunk and limbs are significantly reduced, and the pathological signs are positive). Irradiation treatment parameter selection: irradiation wavelength 808nm, irradiation power 500mW, irradiation for 7-14 days after surgery, and continuous irradiation for 1 hour every day. Therapeutic mechanism: The homogenized light irradiation increases the autophagy of neuronal mitochondria, quickly removes damaged tissues, and enhances the resistance of neurons to hypoxia and oxidative free radical damage.

[0076] Studies have shown that the optical fiber of the present invention is placed above the spinal cord, and the corresponding treatment parameters are used to continuously irradiate the treatment cycle. The safety of columnar uniform light fiber photobiomodulation is evaluated by vital signs (body temperature, blood pressure, respiratory rate, heart rate, blood oxygen saturation), infection indicators (white blood cells, neutrophils, high-sensitivity C-reactive protein, procalcitonin), photoallergic reaction indicators (eosinophils, basophils), coagulation function indicators (prothrombin time, activated partial thromboplastin time and thrombin time) and American Spinal Injury Association sensory and motor scores (American Spinal Injury Association, ASIA). Patients were followed up 3 months after surgery. In our study, direct photobiomodulation of the spinal nerve injury site did not cause clinical changes in the patient's vital signs. On the third day after irradiation, there was no significant difference in the patient's white blood cells, neutrophils and high-sensitivity C-reactive protein compared with the control group. The changes in eosinophils and basophils, which are closely related to allergic reactions, were within the normal range throughout the irradiation process. The coagulation function (prothrombin time, activated partial thromboplastin time and thrombin time) of the patients were all within the normal range. After irradiation treatment, the ASIA sensory and motor scores of all patients were improved.

[0077] The optical fiber of the present invention is placed above the surgically exposed spinal cord of a patient with spinal nerve injury, overcoming the disadvantage that light cannot be directly applied to deeper SCI sites in previous percutaneous or intravascular irradiation treatments. Within the appropriate irradiation parameter range, the use of photobiomodulation therapy directly at the site of spinal nerve injury will not produce adverse reactions. The method is safe, feasible, and does not cause additional trauma to the patient.

Claims

1. A cylindrical homogenous laser optical fiber, the optical fiber comprises a core (1), a cladding (2) and a jacket (5) from the inside to the outside, the core (1) is jacketed in the cladding (2), and the jacket (5) is coated on the outer surface of the optical fiber, characterized in that: At the end of the fiber core (1), according to the design requirements of the columnar light emission length, N sections of scattering monomers (3) or N scattering inflection points (9) are sequentially arranged along the length direction of the fiber core, and a scattering continuum (4) is formed by filling scattering particles (7) in each scattering monomer (3) or continuously writing and arranging the inflection points (9). The cladding (2) of the sleeved fiber core (1) is connected to the scattering continuum (4), so that the laser treatment optical fiber can realize lateral columnar uniform light transmission in a concentrated manner within a target set distance range along the length direction.

2. The columnar light-homogenizing laser optical fiber according to claim 1, characterized in that: If scatterer particles (7) are filled in each scattering monomer (3), different numbers of scatterer particles (7) should be evenly filled in the scattering monomer (3) matrix according to the distance between the longitudinal boundary of each scattering monomer (3) and the end of the fiber core (1), thereby forming a discontinuous and irregular scatterer particle filling distribution in the scattering continuum (4), and a sheath (5) is coated on the outer surface of the optical fiber, so that the laser treatment optical fiber can realize lateral columnar uniform light transmission in a concentrated manner within the target set distance range along the length direction.

3. The columnar light-homogenizing laser optical fiber according to claim 1, characterized in that: If the inflection points (9) are arranged and written continuously, the inflection points (9) should be written non-uniformly and continuously in the scattering continuum (4) by the femtosecond laser system according to the distance between each inflection point (9) and the end of the fiber core, so that the laser treatment optical fiber can realize lateral columnar uniform light transmission in a concentrated manner within the target set distance range along the length direction.

4. The columnar light-homogenizing laser optical fiber according to claim 1, characterized in that: A total reflection cylindrical mirror (8) is also provided at the end of the scattering continuum (4), and the cladding (2) of the sleeved fiber core (1) is butt-jointed with the scattering continuum (4) to form an optical fiber together with the total reflection cylindrical mirror (8), and the outer surface of the optical fiber is coated with a sleeve layer (5).

5. The columnar light-homogenizing laser optical fiber according to claim 1, characterized in that: A coating layer (6) is also coated on the outside of the scattering continuum (4), and the refractive index of the coating layer (6) is required to be lower than the refractive index of the matrix of the scattering monomer (3).

6. The columnar light-homogenizing laser optical fiber according to claim 2, characterized in that: The relative refractive index difference between the fiber core (1) and the matrix of the scattering monomer (3) is less than or equal to 0.15, and the reflectivity of light on the interface between the fiber core (1) and the scattering monomer (3) is less than 5%; The relative refractive index difference between the scattering monomer (3) matrix and the scattering particles (7) is 0.1-0.5; and the refractive index of the coating layer (6) is lower than the refractive index of the scattering monomer (3) matrix.

7. The columnar light-homogenizing laser optical fiber according to claim 3, characterized in that: The fiber core (1) has a refractive index of 1.41, a refractive index of an inflection point (9) of 1.43±1%, and a diameter of 50μm±5μm.

8. The columnar light-homogenizing laser optical fiber according to claim 2, characterized in that: The columnar light emission length is determined according to the application scenario. The columnar light emission length is divided by the number N of scattering monomers (3) to obtain the unit length of the scattering monomers. The unit length of the scattering monomers (3) determines the peak-to-valley fluctuation of the side luminous intensity of the columnar light emission area.

9. The columnar light-homogenizing laser optical fiber according to claim 1 or 2, characterized in that: According to the distance x from the longitudinal boundary of each scattering monomer (3) to the end of the fiber core (1), different numbers of scattering particles (7) are uniformly filled in the scattering monomer (3) matrix; the basis for filling different numbers y of scattering particles (7) is: Among them: A=24674.42±5527.51, B=2781.64±848.73, C=-343.78±164.75, D=13.02±10.21, E=-0.013±0.

179.

10. The columnar light-homogenizing laser optical fiber according to claim 9, characterized in that: The fiber core (1) is low-hydroxyl pure quartz glass, the cladding (2) is fluorine-containing acrylic resin, and the jacket (5) is epoxy resin and / or silica gel.

11. The columnar light-homogenizing laser optical fiber according to any one of claims 1, 2, 4, 5, 6 or 10, characterized in that: The diameter of the scatterer particles (7) is between one and eight times the wavelength of the incident light.

12. The columnar light-homogenizing laser optical fiber according to claim 1, 3 or 7, characterized in that: The inflection points (9) are non-uniformly and continuously written in the scattering continuum (4) by a femtosecond laser system, and the distribution change rule of the inflection points (9) is: in Indicates the serial number of the inflection point; z indicates the distance from the corresponding inflection point to the starting inflection point 0, unit: mm; where: A=0.83265±0.08307, B=1.30798±0.00894, C=-0.01167±0.0002; the maximum value of w is a positive integer in the interval [38, 49].

13. The columnar light-homogenizing laser optical fiber according to any one of claims 1 to 12, characterized in that: This laser fiber is used to treat spinal nerve injuries.

14. The columnar light-homogenizing laser optical fiber according to claim 13, characterized in that: The laser optical fiber is used to treat intervertebral disc herniation, spinal stenosis, spondylolisthesis or traumatic fracture diseases in various segments including the cervical, thoracic, lumbar and sacral vertebrae.

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