经皮椎间盘切除、射频消融治疗包容性腰椎间盘突出症36例  

The Peri-operation Complications and Disposal Strategy on Treatment of Contained Lumbar Disc Herniation by Percutaneous Discectomy Combined with Radiofrequency Ablation by Disc-FX

作　　者：隰建成[1] 马远征[1] 胡明[1] 崔旭[1] 赵文亮[1] 穆小静[1] 

机构地区：[1]解放军第309医院骨科,北京100091

出　　处：《实用骨科杂志》2012年第9期769-771,共3页Journal of Practical Orthopaedics

摘　　要：目的探讨Disc-FX系统经皮椎间盘切除、射频消融术治疗包容性腰椎间盘突出症的并发症及处置对策。方法选择自2010年7月至2011年6月在我院应用Disc-FX系统经皮椎间盘切除、射频消融术治疗包容性腰椎间盘突出症患者36例,其中男16例,女20例;年龄18～77岁,比较术前、术后即刻、1周、3个月、6个月、1年的日本骨科协会(Japanese orthopaedic association,JOA)、视觉模拟疼痛(visual analogue scale,VAS)及Oswestry(2.0版本)评分,分析术中、术后并发症的情况。结果本组均获随访,随访时间3个月～1年,平均8个月,36例患者术后JOA评分较术前明显升高,术后VAS和Oswestry评分较术前明显降低,有统计学意义(P<0.01)。术中并发症包括:a)导针断裂1例;b)神经根挫伤1例。术后并发症包括:a)术后水肿反应24例;b)终板炎1例;c)椎间隙感染1例;d)手术局部血肿1例。结论 Disc-FX系统经皮椎间盘切除、射频消融术是治疗包容性腰椎间盘突出症的有效方法。严格的围手术期处理和谨慎的术中操作可预防或减少并发症的发生。Objective To investigate complications and disposal strategy on contained lumbar disc herniation by percutaneous discectomy combined with radiofrequency ablation by Disc-FX.Methods The patients′preoperative and postoperative JOA,VAS and Oswestry（version 2.0） score and preoperative and postoperative complications in contained lumbar disc herniation from 2010.7.to 2011.6 were analysed.The time of follow-up was 3 months～1 year.the average time of follow-up was 8 months.Results Postoperative JOA score was significantly increased compared with preoperative score（P〈0.01）.Postoperative VAS and Oswestry score decreased significantly compared with preoperative score（P〈0.01）.The common complications during operation included guide pin broken,contusion of nerve root,rupture of huge blood vessel.The common postoperative complications included postoperative edema response,phlegmonosis of end plate,infection.Conclusion Contained lumbar disc herniation can be effectively treated with percutaneous discectomy combined with radiofrequency ablation by Disc-FX.The complications can be prevented and diminished by strict perioperative treatment and prudent manipulation.

关 键 词：Disc-FX系统 经皮椎间盘切除 射频消融 包容性腰椎间盘突出 并发症 

分 类 号：R681.53[医药卫生—骨科学]