后外侧和小关节内侧双入路椎间盘内臭氧注射治疗巨大型腰椎间盘突出症  

Treatment of Huge Lumbar Disc Heniation with Percutaneous Ozone Injection Through Posterolateral and Inner Margin of Facet Joint Approch

作　　者：卢伟[1] 何晓峰[1] 梅雀林[1] 秦耿耿[1] 陈勇[1] 赵剑波[1] 韦传军[1] 曾庆乐[1] 陈正喜[1] 邹嵩[1] 刘战胜[1] 许小立[1] 张丹[1] 张彤[1] 冯建宇[1] 李彦豪[1] 

机构地区：[1]南方医科大学附属南方医院介入治疗科,广州510515

出　　处：《临床放射学杂志》2008年第12期1741-1744,共4页Journal of Clinical Radiology

摘　　要：目的比较经后外侧和小关节内侧双入路椎间盘内臭氧(O3)注射与单纯后外侧入路O3注射对治疗巨大型(突出>5mm)腰椎间盘突出症的疗效。资料与方法105例患者均在DSA监视引导下行椎间盘O3注射治疗,其中58例经后外侧和小关节内侧双入路椎间盘内O3注射治疗(A组),47例采用单纯后外侧入路O3注射治疗(B组)。所有患者5天后均重复注射1次,随访6～18个月。采用MacNab腰腿痛评价标准评价并比较两组疗效。结果两组穿刺操作成功率均为100%。按照MacNab评价标准,A组显效37例(63.8%),有效16例(27.6%),无效5例(8.6%),总有效率为91.4%。B组显效22例(46.8%),有效15例(31.9%),无效10例(21.3%),总有效率为78.7%。两组比较差异有统计学意义(χ2=4.269,P=0.027)。两组均未发生严重并发症。结论经后外侧和小关节内侧双入路椎间盘内O3注射是治疗巨大型腰椎间盘突出症的一种安全、有效方法,疗效优于单纯后外侧入路治疗。Objective To compare the efficacy of percutaneous ozone injection through posterolateral and inner margin of facet joint approach with that of through the route of posterolateral in the treatment of huge lumbar disc heniation. Materials and Methods one hundred and five patients with huge lumbar disc heniation were treated with pereutaneous ozone injection. 58 paitents were treated with percutaneous injection of ozone through the route of posterolateral and inner margin of facet joint （group A）, 47 patients were injected ozone through the route of posterolateral under digital subtraction angiography （DSA）. Second injections were performed 5 days after the initial injection. All patients were follow up 6-18 months. The clinical efficiency was assess using Modified MacNab method. The outcomes of group A were compared with that of group B. Results Successful punctures were obtained in all patients. In group A, the efficacy was 91.4 % with the excellent in 37 cases （63.8%）, good in 16 cases （27.6%） and fair/poor in 5 cases （8.6%）. In group B, the effective rate was 78.7% with excellent in 22 cases （46.8%）, good in 15 cases （31.9%） and fair/poor in 10 cases （21.3%）. Statistical difference exhibited between groups A and B （X^2 = 4. 269 ,P = 0. 027 ）. No severe complication was found in this study. Conclusion Pereutaneous intradiscal ozone injection through the route of posterolateral and inner margin of facet joint is an effective and safe method for treatment of huge lumbar disc heniation. It is superior to intradiseal ozone injection through the route of posterolateral alone in the treatment of huge lumbar disc heniation.

关 键 词：腰椎间盘突出症 椎关节突关节 臭氧 

分 类 号：R681.5[医药卫生—骨科学]