射频消融髓核成形术后颈椎间盘内压力的变化  

Pressure changes in cervical disc after percutaneous radiofrequency nucleoplasty

作　　者：张维成[1] 麦伟[1] 廖兴华[1] 黄晓魏[1] 方文焕[1] 李智[1] 

机构地区：[1]广东省湛江中心人民医院骨科,524037

出　　处：《中国医师进修杂志》2010年第5期17-20,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的观察射频消融髓核成形术对颈椎间盘内压力的影响，以提供射频消融髓核成形术治疗颈椎间盘突出症的理论依据。方法应用射频消融髓核成形术治疗颈椎间盘突出症患者42例（神经根型颈椎病33例，椎动脉型颈椎病9例），于射频消融前后分别测量颈椎间盘内压力，并于术后1周采用日本骨科学会（JOA）评分评估其疗效，探讨颈椎间盘内压力的变化与临床疗效之间的关系。结果射频消融髓核成形术后，33例神经根型颈椎病患者颈椎间盘内压力较术前降低（1．84±0．96）kPa（P=0．000），术后1周JOA评分较术前升高（3．27±1．35）分（P=0．000）；9例椎动脉型颈椎病患者颈椎间盘内压力较术前降低（1．72±0．92）kPa（P=0．000），术后1周JOA评分较术前升高（2．78±0．67）分（P=0．000）。相关分析表明椎间盘内压力的降低程度与JOA评分的升高程度呈显著正相关（P〈0．05）。结论射频消融髓核成形术可以降低颈椎间盘内压力，从而达到缓解临床症状的目的。Objective To study the changes of pressure in cervical disc after percutaneous radiofrequency nucleoplasty,and provide theoretical basis for percutaneous radiofrequency nucleoplasty in the treatment of cervical disc herniation. Methods Forty-two patients with cervical disc herniation （33 cases of nerve root-type cervical spondylopathy and 9 cases of vertebral artery-type cervical spondylopathy） were treated with percutaneous radiofrequency nucleoplasty. The pressures of operated cervical disc were measured in the operation, and their clinical effects were evaluated using the JOA values 1 week after operation. The relationship between pressure changes in cervical disc and clinical effect was studied. Results The pressure in the cervical disc in 33 cases of nerve root-type cervical spondylopathy was decreased （ 1.84 ± 0.96） kPa （P=0.000）, and the JOA values increased （3.27 ± 1.35） scores （P=0.000） 1 week after operation. The pressure in the cervical disc in 9 cases of vertebral artery-type cervical spondylopathy was decreased （ 1.72 ± 0.92） kPa （P = 0.000 ）, and the JOA values increased （2.78 ±0.67 ） scores （P = 0.000 ） 1 week after operation. Correlative analysis showed that there was a positive correlation between the pressure decrease of cervical disc and the JOA values increase （P 〈 0.05 ）. Conclusion Percutaneous radiofrequency nucleoplasty can help to reduce pressure in the cervical disc and relieve the clinical symptoms.

关 键 词：颈椎 椎间盘移位 压力 射频消融髓核成形术 

分 类 号：R687.3[医药卫生—骨科学] R681.53[医药卫生—外科学]