Disc—FX通道系统辅助下治疗椎间盘源性腰痛的早期疗效观察  

Primary results of the 3-in-1 technique of Disc-FX system for the discogenic low back pain

作　　者：张为[1] 王会旺[1] 焦甲勋[1] 王云霞[1] 杨大龙[1] 丁文元[1] 申勇[1] 

机构地区：[1]河北医科大学第三医院脊柱外科,石家庄050051

出　　处：《中华骨科杂志》2011年第10期1049-1055,共7页Chinese Journal of Orthopaedics

摘　　要：目的探讨在Disc—FX通道系统辅助下采用髓核摘除、射频消融和纤维环成型的“三合一”技术治疗椎间盘源性腰痛的早期临床疗效。方法2010年2月至2011年2月，我院对40例椎间盘源性腰痛患者行Disc—FX通道系统辅助下的“三合一”技术治疗，其中男22例，女18例；年龄32-58岁，平均38．7岁。对治疗前和术后1周、3个月、6个月及末次随访时的腰痛视觉模拟评分（visual analogscale，VAS）、下肢痛VAS评分及末次随访Macnab评分进行对比分析。结果手术时间20-40min，平均26min。术后随访6－18个月，平均13．8个月。术后未发现手术相关并发症。术后1周、3个月、6个月以及末次随访时腰痛VAS评分分别为：（1．05±0．68）分、（1．15±0．70）分、（1．00±0．62）分和（0．95±0．63）分，与术前腰痛VAS评分（6．60±1．47）分比较差异均有统计学意义；术后1周、3个月、6个月及末次随访时下肢疼痛VAS评分分别为（1．10±0．74）分、（1．15±0．70）分、（1．10±0．72）分和（0．95±0．54）分，与术前（3．05±1．23）分比较差异均有统计学意义。按照Macnab评分标准，末次随访时优20例，良17例，可2例，差1例，优良率为92．5％（37／40）。1例患者术后1个月时复发。结论Disc—FX系统辅助下的“三合一”技术治疗椎间盘源性腰痛短期内能取得满意疗效，但其远期效果仍待进一步观察。Objective To investigate the clinical efficacy of the 3-in-1 technique of Disc-FX system, namely： discectomy, radiofrequency ablation and annnloplasty for discogenic low back pain in the early stage. Methods From February 2010 to February 2011, 40 patients with the discogenic low back pain underwent discectomy, radiofrequency ablation and annuloplasty using Disc-FX system were retrospectively analyzed, including 22 males and 18 females with an average age of 38.7 years （range, 32-58 years）. The visual analogue scale （VAS） scoring was applied to evaluate the back and low limb pain at preoperative, postoperative 1 week, 3 months, 6 months, and last follow-up.The Macnab score was also evaluated at last follow-up. Results All the patients were followed up for average 13.8 months （range, 6-18 months）. The operative time averaged 26 min （range, 20-40 min）. No surgical complication was found during the follow-up. The VAS of preoperative low back pain was 6.60±1.47, VAS score of low back pain at postoperative 1 week, 3 months, 6 months, and final follow-up were 1.05±0.68, 1.15±0.70, 1.00±0.62, 0.95±0.63, respectively. The postoperative VAS of low back pain decreased significantly compared with that preoperative. The VAS of preoperative limb pain was 3.05±1.23, VAS score of limb pain at postoperative 1 week, 3 months, 6 months, and final follow-up after operation were 1.10±0.74, 1.15±0.70, 1.10±0.72, 0.95±0.54, respectively. The postoperative VAS of limb pain decreased significantly compared with that preoperative. The evaluation of Macnab score were excellent in 20 patients, good in 17, fair in 2, and poor in 1, suggesting an effective rate of 92.5% （37/40）. Conclusion Disc-FX system, which combined three surgical technique in one procedure, provides a new choice for orthopedics to treat discogenic low back pain. It can give satisfactory clinical outcomes during a short-term followup, but the long term clinical outcomes remains unknown.

关 键 词：腰痛 椎间盘切除术 经皮 导管消融术 

分 类 号：R687.3[医药卫生—骨科学]