手术配合术后银质针治疗腰椎运动单元失稳的软组织疼痛  

Operative combined with postoperative silver needle treatment for the lumbar motor unit instability soft tissue pain

作　　者：董宏然[1] 王全美[1] 吴华山[1] 

机构地区：[1]南京军区总医院汤山住院部,江苏南京211131

出　　处：《颈腰痛杂志》2009年第6期486-488,共3页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨腰椎运动单元失稳的难治性软组织疼痛有效的治疗方法。方法对110例患者采用经腰椎后路有限松解椎管外软组织,切除椎管内病变的软组织包括损害的椎间盘,切除压迫神经根及硬脊膜囊的增生骨组织,同时对失稳节段经椎弓根钉棒系统固定及椎体间融合术。术后对部分残留椎管外软组织损害性疼痛病灶患者配合银质针治疗。结果手术无严重的并发症及后遗症,经平均2年8个月的随访,优良率96.4%。结论一切因素引起的腰椎运动单元失稳,椎管内外软组织、椎间盘及后小关节囊均受累。因为腰椎运动单元失稳引起伤害性感受的范围涉及到椎管内外及失稳节段连接处的软组织,所以治疗的范围应考虑到多方位的立体治疗。针对压痛点行银质针治疗,可以消除或部分消除手术未涉及到的椎管外损害的软组织中的感受器,从而去除残留痛及因之而引起的牵涉痛。Objective To explore the lumbar motor unit instability intractable soft tissue pain and effective treatment. Methods 110 eases were treated with limited release the soft tissue outside the posterior lumbar spinal canal,resection of intraspinal diseased soft tissue and spondylopathy,ineluding the damaged disc,release lumbar nerve root and dura,Pedicle screw-rod system fixation instability and fusion of the vertebral body. After addition of some residual spinal soft tissue pain in patients were treated with the silver needle. Results Surgery without serious complications and lingering effects,average follow-up time 24 months ,the rates of excellent and good were 96.4%. Conclusion All factors of lumbar motor unit instability, Both inside and outside the spinal soft tissue,lumbar intervertebral disc and facet joint capsule were involved.Lumbar motor unit instability caused by the scope of nociceptive related to the soft tissue both inside and outside spinal canal and instability junction,so the scope of treatment should take into account the muhi-faceted three-dimensional. Tenderness point for the treatment of silver needle,can be eliminated or in part the chemoreceptor of the soft tissue outside the spinal canal that surgery did not involve,In order to remove the residual pain and therefore referred pain caused by.

关 键 词：腰椎运动单元失稳 软组织痛 松解手术 稳定性手术 银质针治疗 

分 类 号：R681.55[医药卫生—骨科学]