CT引导下臭氧髓核消融联合糖皮质激素椎小关节注射治疗腰椎间盘突出症并椎小关节病变  

CT-guided intradiscal ozone injection combined with intervertebral facet joint steroid injection for lumbar disk herniation accompanied with intervertebral arthritis

作　　者：张莉[1] 李家开[2] 陈照徽[1] 孙西俊[1] 刘建平[1] 

机构地区：[1]兰州市第二人民医院影像科,730046 [2]中国人民解放军总医院放射科

出　　处：《介入放射学杂志》2009年第11期853-855,共3页Journal of Interventional Radiology

摘　　要：目的臭氧(O3)髓核消融术联合椎小关节局部复方倍他米松注射治疗腰椎间盘突出症并椎小关节炎患者的疗效观察。方法80例腰椎间盘突出并椎小关节炎患者随机分为两组,在CT引导下,Ⅰ组(n=40)单纯椎间盘穿刺臭氧消融术,注射50μg/ml O3 10～20 ml,Ⅱ组(n=40)行椎间盘穿刺臭氧消融的同时在双侧或单侧椎小关节注射复方倍他米松注射液0.5～1 ml,两组患者分别在术前与术后1周,3、6个月采用双盲法Oswestry Low Back Pain Disability量表评估疗效。结果术后第1周Ⅰ组和Ⅱ组有效率分别为65%和82.5%;3个月有效率分别为75%和90%;6个月时分别为70%和92.5%。Ⅱ组较Ⅰ组病例在1周、3、6个月疗效均显著增高(P<0.05)。结论椎间盘臭氧消融联合椎小关节药物局部注射是治疗椎间盘突出并椎小关节炎的一种有效、安全的方法,值得推广应用。Objective To compare the clinical effectiveness of ozone（O3） nucleus pulposus ablation only with that of O3 nucleus pulposus ablation combined with intervertebral facet joint injection of compound Betamethasome in treating lumbar disk herniation accompanied with intervertebral facet arthritis.Methods Eighty patients with lumbar disk herniation and intervertebral facet arthritis were equally and randomly divided into two groups.Under CT guidance,O3 nucleus pulposus ablation was performed in patients of group A（n = 40）,while O3 nucleus pulposus ablation combined with intervertebral facet joint injection of compound Betamethasome（0.5 ～ 1 ml） was carried out in patients of group B（n = 40）.Using double blind method the therapeutic effectiveness was evaluated before and 1 week,3,6-months after the procedure by an Oswestry Low Back Pain Disability Questionnaire.Results One week after the procedure the effective rate of group A and group B was 65% and 82.5% respectively.Three and six months after the treatment,the effective rate was 75% and 70% respectively for group A,while it was 90% and 92.5% respectively for group B.The difference between two groups was significant（P 〈 0.05）.Conclusion Intradiscal injection of O3 combined with intervertebral facet joint injection of compound Betamethasome is an effective and safe treatment for lumbar disk herniation accompanied with intervertebral facet arthritis.It is worth popularizing this technique in clinical practice.

关 键 词：腰椎间盘突出 椎小关节炎 CT引导 臭氧 

分 类 号：R681.53[医药卫生—骨科学]