经皮臭氧靶点注射治疗重度腰椎间盘突出症疗效分析  

Effect of Percutaneous Targeted Injection of Ozone in the Treatment of Large Lumbar Disc Herniation By Posterior Approach Via Spinal Canal and Dural Sac

作　　者：俞志坚[1] 王保安[1] 罗文志 

机构地区：[1]南方医科大学珠江医院放射科,广州510282 [2]广东省翁源县人民医院放射科,512600

出　　处：《临床放射学杂志》2012年第10期1466-1469,共4页Journal of Clinical Radiology

基　　金：广东省医学科学技术基金资助项目(编号:A2011362)

摘　　要：目的评估CT介导下后入路经椎管及硬膜囊椎间盘内医用臭氧注射治疗重度腰椎间盘突出症的疗效及优势。方法 36例重度腰椎间盘突出症患者于CT介导下从背部棘突旁开约1～2 cm后入路经椎管及硬膜囊穿刺到达椎间盘内,臭氧注射于椎间盘、突出髓核及患侧硬膜外间隙神经根周围。椎间盘及突出髓核内医用臭氧浓度为40～50μg/ml,神经根旁医用臭氧浓度为30μg/ml。结果 36例患者均治疗成功。术前平均下肢根性痛视觉模拟评分(VAS)为(8.34±1.62)分,Oswestry功能障碍指数(ODI)评分平均为(61.75±12.44)分;术后6个月随访VAS评分平均为(3.97±0.53)分,ODI评分平均为(38.28±7.76)分;术前及术后VAS及ODI评分差异均有统计学意义(P值均<0.001)。按照ODI评分区段分布,5例达到优,21例达到良,7例可,3例差,总优良率达72.2%。15例共注射臭氧2次,13例(86.7%)取得优良疗效。全部患者均未见严重并发症。结论 CT介导下后入路经椎管及硬膜囊腰椎间盘内医用臭氧注射治疗重度腰椎间盘突出症安全、注射准确、疗效好,可作为备选方法,根据实际情况选择应用。Objective To evaluate the effect and advantage of the treatment of large lumbar disc herniation with percutaneous medical ozone exact injection by posterior approach via spinal canal and dural sac under CT guidance.Methods Under CT guidance,needle was punctured percutaneously into lumbar intervertebral disc by posterior approach paramedian 1~2cm from spinous process（around nerve root） in all 36 cases.The target points of medical ozone injection were affected lumbar discs,protruded nucleus pulposus and ipsilateral lateral recess.The concentration of ozone was 40-50 μg/ml in the disc/protruded nucleus pulposus and 30 μg/ml in the lateral recess respectively.Results The treatment procedures were successful in all 36 patients.The average scores of VAS and ODI before treatment were（8.34±1.62） and（61.75±12.44） respectively,and those after treatment were（3.97±0.53） and（38.28±7.76） respectively.There were significant difference statistically comparing the average scores of VAS and ODI before treatment with those at final follow up（all P〈0.001） respectively.The total success rate according to the interval distribution of ODI scores was 72.2% with 5 cases considered excellent effect,21 cases good effect,7 cases slightly improved and 3 cases poor effect.The 15 patients with 2 treatments of ozone injection showed satisfactory effect with the successful rate of 86.7%（13/15）.No patient complained of any serious complications.Conclusion Percutaneous medical ozone injection into intervertebral disc by the routine of posterior approach close to the facet under CT guidance is a procedure that is safe,can reach the target points,and yields good the rapeutic effect for the treatment of large lumbar disc herniation.It can be used as an alternative method.

关 键 词：椎间盘突出症 腰 臭氧 体层摄影术 X线计算机 靶点注射 疗效 

分 类 号：R681.53[医药卫生—骨科学]