CT导引下臭氧髓核消融术治疗腰椎间盘突出症的研究  

Clinical research of CT imaging change in CT-guided injection of ozone in the treatment of lumbar intervertebral disc heniation

作　　者：徐文科 刘立华 袁庆杰 

机构地区：[1]山东潍坊寒亭区人民医院,山东261100 [2]山东潍坊寒亭区人民医院南孙分院

出　　处：《当代医学》2012年第6期86-87,共2页Contemporary Medicine

摘　　要：目的探讨CT导引下臭氧髓核消融术治疗腰椎间盘突出症术中CT表现变化的规律性。方法 320例患者均经CT或MR证实为椎间盘突出症(400个椎间盘),临床表现均为腰腿疼以及下肢麻木、活动受限,其中单纯腰间盘突出200例(中央型80例,偏侧型85例,神经根管型35例),多节椎间盘疾患的70例(三节椎间盘病变的10例,二节椎间盘病变的60例),单纯膨出48例,脱出2例(为脱出游离型)。俯卧位CT定位,测量进针深度及角度,局麻下用18-21G日本产八光穿刺针经皮穿刺椎间盘,实施臭氧髓核消融术,盘内注射浓度为60μg/ml,首次注射剂量为5～20ml,根据患者症状缓解情况注射,然后行CT扫描察看椎间盘CT表现改变情况后,决定具体注射总剂量,总量约在20～120 ml/间盘,椎旁间隙浓度40μg/ml,剂量为10ml,再次CT扫描记录椎间盘CT表现情况,CT表现达到要求后结束治疗。结果所有400个椎间盘大多数有气化改变,症状改善总显效235例(73.44%),有效65例(23.16%)微效11例(3.40%),没有明显并发症。结论 CT导引下臭氧髓核消融术是治疗腰椎间盘突出症的微创治疗手段之一,具有疗效显著,立竿见影等特点,治疗过程中具有不同CT表现变化,虽然变化复杂但具有一定的规律性。Objective To explore the regularity of CT imaging change in CT-guided injection of ozone in the treatment of lumbar intervertebral disc heniation. Methods All 320 patients with lumbar intervertebral disc heniation （400 lumbar intervertebral discs） were diagnosed by CT or MRI. The clinical manifestation was lumbago, leg pain, acroanesthesia and limitation of motion. There were 200 cases with herniation, 48 cases with bulge and 2 cases with prolapse. CT position fixing with face lying, then measuring the depth and angle of the needling insertion, to puncture the intervertebral disc with 18-21G needle under local anesthesia, then injected 5-20ml of 60pg/ml ozone in the intervertebral disc, and took CT scan to observe the change of intervertebral disc. The total dosage of ozone was 20-120ml each disc, 10ml of 60btg/ml ozone was injected into the paravertebral interspace, then took CT scan again to observe the change of intervertebral disc. Results Mainly of all 400 discs had gasification, the gasification was like apple, irregular, fissuring or no change. Evaluating therapy effect by follow-up, the total great effective rate was 73.44%, the total effective rate was 23.16%, the little effective rate was 3.1%. there was no severe complication. Conclusion CT-guided injection of ozone in treatment of lumbar inervertebral disc heniation is an effective method. There is different CT imaging in different type of lumbar intervertebral disc heniation.

关 键 词：腰椎间盘突出症 CT 影像学变化 臭氧髓核消融术 

分 类 号：R681.53[医药卫生—骨科学]