探讨CT引导下椎间盘内射频电刺激定位法在椎间盘源性腰痛手术治疗中的应用价值  

Explore the Value of CT-Guided Radiofrequency Electrical Stimulation Localization in the Surgical Treatment of Discogenic Low Back Pain

作　　者：熊丽琴 王亚瑟 冯金坤 李妍玲 贺芳[1] 张燚坤 刘辉[1] 胡君 XIONG Liqin;WANG Yase;FENG Jinkun(Department of Radiology,Wuhan Municipal Wuchang Hospital,Wuchang Hospital Affiliated to Wuhan University of Science and Technology,Wuhan,Hubei Province 430063,P.R.China)

机构地区：[1]武汉市武昌医院(武汉科技大学附属武昌医院)放射科,430063 [2]武汉市武昌医院(武汉科技大学附属武昌医院)针灸科,430063 [3]湖北省中医院放射科,武汉430063

出　　处：《临床放射学杂志》2020年第10期2046-2049,共4页Journal of Clinical Radiology

基　　金：武汉市卫计委课题项目(编号:WX19D34)

摘　　要：目的探讨CT引导下椎间盘内射频电刺激定位法在椎间盘源性腰痛手术治疗中的应用价值。方法选取80例椎间盘源性腰痛患者作为研究对象,所有患者均经影像学检查明确为椎间盘源性腰痛,并在CT引导下行椎间盘内射频电刺激定位主要责任椎间盘。根据电刺激诱发试验结果将80例腰痛患者分为刺激诱发试验阳性组与阴性组,所有患者均接受椎间盘低温等离子纤维环成形术治疗,随访观察患者术后腰痛及功能改善情况。结果根据电刺激诱发实验结果显示,刺激诱发试验阳性组共65例,阴性组15例。所有患者均未发生任何严重并发症,且两组患者手术用时、术中出血量、住院时间比较无显著差异(P>0.05),差异无统计学意义;两组治疗前JOA评分分析比较无显著差异(P>0.05),治疗后阳性组腰椎疾患综合情况改善作用明显优于阴性组(P<0.05);两组治疗前疼痛数字评分(NRS)比较无显著差异(P>0.05),术后1周、1个月、6个月时阳性组患者NRS评分明显低于阴性组(P<0.05),差异具有统计学意义;阳性组患者MacNab评分优良率明显高于阴性组,差异具有统计学意义(P<0.05)。结论CT引导下椎间盘内射频电刺激试验有助于精确定位椎间盘源性腰痛患者的主要责任腰间盘,并且刺激诱发试验阳性的椎间盘源性腰痛患者经低温等离子纤维环手术治疗后能够有效改善腰痛及功能障碍程度,治疗效果及患者主观满意度较高,具有临床应用及推广价值。Objective To Investigate the value of CT-guided radiofrequency electrical stimulation localization in the surgical treatment of discogenic low back pain.Methods 80 patients with discogenic low back pain who were treated in our hospital from December 2017 to January 2019 were selected as the study subjects.All patients were diagnosed with discogenic low back pain by imaging examination,and the main responsibility of disc location was radiofrequency electrical stimulation under CT guidance.According to the results of electrical stimulation induction test,80 patients with low back pain were divided into positive group and negative group.All patients received low temperature plasma annulus of intervertebral disc,plastic treatment,follow-up observation of postoperative low back pain and functional improvement.Results According to the results of the stimulation test,there were 65 cases in the positive group and 15 cases in the negative group.No serious complications occurred in all patients,and there was no significant difference in operation time,intraoperative bleeding volume and hospitalization time between the two groups(P>0.05).There was no significant difference in NRS score between the two groups before treatment(P>0.05),and NRS score in the positive group at 1 week,1 month and 6 months after treatment.The score of the positive group was significantly lower than that of the negative group(P<0.05).The excellent and good rate of MacNab score in the positive group was significantly higher than that in the negative group(P<0.05).Conclusion CT-guided radiofrequency electrical stimulation test is helpful to accurately locate the main cause of lumbar disc in patients with discogenic low back pain.Stimulation-induced test-positive patients with discogenic low back pain can effectively improve the degree of low back pain and dysfunction after low temperature plasma annulus surgery.

关 键 词：螺旋CT引导 椎间盘内射频电刺激定位 椎间盘源性腰痛 责任椎间盘 低温等离子纤维环成形术 临床疗效 

分 类 号：R687.3[医药卫生—骨科学] R816.8[医药卫生—外科学]