等离子髓核成形术治疗腰椎间盘源性疼痛远期疗效的分析  

The discogenic pain treated by coblation nucleoplasty was analyzed efficacy in longer term

作　　者：杜随勇[1,2] 李放[1] 张志成[1] 赵广民[1] 朱兵[1] 朱和玉[1] 

机构地区：[1]北京军区总医院全军创伤骨科研究所,100070 [2]山西医科大学

出　　处：《中华临床医师杂志（电子版）》2012年第11期88-91,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探讨髓核成形术治疗腰椎间盘源性疼痛的5年随访疗效。方法对获得5年以上随访的41例诊断为腰椎间盘源性疼痛患者使用等离子髓核成形术后进行疗效分析,采用患者主观满意度、视觉疼痛模拟评分(VAS)及Oswestry功能障碍指数(ODI)评分,对患者腰腿疼缓解和日常生活状况进行疗效评估。结果所有患者手术顺利实施,术后1例患者发生椎间盘炎,末次随访患者主观满意度为63.4%;术前、术后1周、术后3年、术后5年VAS评分分别为(7.9±0.7)分、(3.4±0.5)分、(2.9±0.4)分、(2.5±0.4)分;术前、术后1周、术后3年、术后5年ODI评分分别为(58.9±6.1)分、(42.1±4.2)分、(25.4±4.0)分、(23.0±2.9)分;术前、术后1周、术后3年的VAS及ODI评分有统计学差异(P<0.05),术后3年、术后5年的VAS及ODI评分不具有统计学差异(P>0.05)。椎间隙、椎间盘退变MRI分级、椎间盘造影诱发试验的分类均有统计学差异(P<0.05)。结论在长达5年的随访研究中,等离子髓核成形术对椎间盘源性疼痛患者获得较为满意的临床疗效,但仍需大样本的随机对照试验。Objective To evaluate longer term efficacy over five-years follow-up of coblation nucleoplasty treatment for the discogenic pain.Methods forty-one cases of the discogenic pain treated by coblation nucleoplasty were analysed.Patient＇s subjective satisfaction,relief of low back pain or leg pain and daily living of patient after operation were assessed by Visual Analogue pain Scale（VAS）and the Oswestry Disability Index（ODI）.Results Operations were performed successfully in all cases.One patient after operation had discitis.During at the last following-up,patient＇s subjective satisfaction was 63.4%;VAS respectively were（7.9±0.7）,（3.4±0.5）,（2.9±0.4）,（2.5±0.4）at pre-operation,at one-week after the operation,at three-years after the operation,at five-years after the operation.ODI respectively were（58.9±6.1）,（42.1±4.2）,（25.4±4.0）,（23.0±2.9）at pre-operation,at one-week after the operation,at three-years after the operation,at five-years after the operation.There were statistically significant difference between the classification of intervertebral pace,MRI manifest and evoked the discogenic pain（P0.05）.Conclusions Coblation nucleoplasty may have satisfactory clinical outcomes for treatment the discogenic pain for as long as five-years follow-up,but a randomized controlled trial of big sample still were needed.

关 键 词：外科手术 微创性 椎间盘 疼痛 等离子髓核成形术 

分 类 号：R687.3[医药卫生—骨科学]