椎间盘内电热疗法进展  

Advance in the intradiscal electrothermal treatment

作　　者：李瓦里[1] 孙波[1] 王平[1] 

机构地区：[1]天津中医药大学第一附属医院骨科,天津300193

出　　处：《中国骨伤》2007年第3期214-215,216,共3页China Journal of Orthopaedics and Traumatology

摘　　要：慢性持续性下腰痛是一种常见症状,多数是由椎间盘退变(internal disc disruption,IDD)所引起。致痛原因可能是盘外层纤维环受损引起细小神经激惹或盘内瘢痕组织内的神经受压激惹。解除疼痛的办法就是修复加强磨损脆弱的纤维环和灭活盘内痛性细小神经。椎间盘内电热法纤维环整形术(IDET)作为治疗下腰痛的一种新方法,应用到脊柱外科的临床,将特制的热疗导索经腰背部的皮肤穿刺,进入椎间盘,沿纤维环的环状板层结构顺行,直接使热能作用于病灶。这一疗法主要有2个方面的作用:①局部热疗使纤维环组织中的胶原纤维收缩,发生再塑形,可能使撕裂处愈合;②热能使分布在纤维环外层的痛觉神经末梢灭活,使之失去接收和传递疼痛信号的能力。其临床效果满意,但强调在应用IDET时,必须严格掌握适应证。Low back pain is a common symptom, and it＇s main cause is internal disc disruption（IDD）. The reasons of pain maybe tiny nerves irritated by the damage of the out layer of the annular fibrosus, or because of nerves compressed by scar tissues in the disc. The method to relieve the pain is to repair or strengthen weared annuli fibrosl and deactivate the nervelet. Intradiscal electrothemal anuloplasty（IDET） is applied to the treatment of low back pain as a new therapy method. It＇s operating provedure is to put a tailor - made thermotherapy guide cable into the disc space, proceed along the layers of the annuli fibrosi and heat the nucleus pulposus. The effects of this method include： ① local high temperature made collagen fibers contract and re-mould, which induced tear part healed; ③heat energy made pain nerve ending which distributes the outer layer of annulus fibrosus inactivated and lost ability to receive and transfer pain signal. IDET is effective to trest low back pain, but its indication should be controled strictly when applied.

关 键 词：椎间盘 腰痛 电刺激疗法 

分 类 号：R681.5[医药卫生—骨科学]