经皮射频消融髓核成形术治疗椎间盘源性腰痛  

Percutaneous Radiofrequency Nucleoplasty on the Treatment of Discogenic Low Back Pain

作　　者：冯晶[1] 肖少雄[1] 杨成胜[1] 夏平[1] 熊伟[1] 

机构地区：[1]武汉市第一医院骨科,武汉430022

出　　处：《中国中医骨伤科杂志》2010年第4期36-38,共3页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:探讨经皮射频消融髓核成形术治疗椎间盘源性腰痛(discogenic low back pain DLBP)的临床疗效及其对腰椎稳定性的影响。方法:对我院2005年5月～2009年5月因DLBP住院行经皮射频消融髓核成形术治疗的154例患者进行回顾性研究,临床效果评价采用视觉模拟疼痛评分VAS及Macnab疗效评价标准,手术前后腰椎稳定性评价采用Panjabi提出的腰椎失稳的X线诊断标准,比较术后24h、1周、1月、1年、2年的临床效果与腰椎稳定性。结果:152例患者获随访,随访24～36个月,平均25.6个月。术后VAS评分较术前明显改善(P<0.001),术后各组缓解率比较,差异无统计学意义(P>0.05)。Macnab疗效评价标准术后优良率分别为87.0%(1d)、90.9%(1周)、87.6%(1月)、86.1%(1年)、76.3%(2年),差异无统计学意义(P>0.05)。手术后各时间点无腰椎失稳病例;腰椎稳定性手术前后比较差异无统计学意义(P>0.05)。结论:经皮射频消融髓核成形术治疗DLBP的临床疗效优良,对腰椎稳定性影响小,不会造成腰椎失稳的发生。Objective：To explore the therapeutic effect of percutaneous radiofrequency nucleoplasty on the treatment of discogenic low back pain（DLBP） and the mechanical effect on lumbar spine stability.Methods：A retrospective study of 154 cases with DLBP operated by percutaneous radiofrequency nucleoplasty from May 2005 to May 2009 was performed.The clinical outcome was evaluated by visual analog scale（VAS） score and efficacy evaluation criteria Macnab,and lumbar stability was assessed by X-ray diagnostic criteria of lumbar spine instability proposed by Panjabi.The clinical and mechanical result of lumbar spine was compared at postoperative 24 h,1 week,1 month,1 year and 2 years.Results：One hundred and fifty-two cases were followed up for 24 months to 36 months（averagely 25.6 months）.All cases had been successfully operated.There was a significant difference in VAS score before and after the treatment（P〈0.001）,but no marked difference was found in the remission rate after the operation（P〉0.05）.The cure rates of Macnab results were 87.0%（24h postoperatively）,90.9%（1 week）,87.6%（1 month）,86.1%（1 years）,and 76.3%（2 years）.No significant difference was found among all postoperative groups（P〉0.05）.There was no case with instability of lumbar vertebra in all groups after operation,and there was no significant difference of lumbar vertebra stability in each group before and after operation（P〉0.05）.Conclusion：Percutaneous radiofrequency nucleoplasty on the treatment of DLBP has good outcomes without any effect on the stability of lumbar spine.

关 键 词：经皮射频消融髓核成形术 椎间盘源性腰痛 腰椎稳定性 

分 类 号：R681.53[医药卫生—骨科学]