C形臂X线引导下针刀切断脊神经后内侧支治疗腰椎关节突骨关节炎的病例对照研究  

Case-control study on needle-knife to cut off the medial branch of the lumbar posterior ramus under C-arm guiding for the treatment of low back pain caused by lumbar facet osteoarthritis

作　　者：卢笛[1] 徐卫星[1] 丁伟国 郭峭峰[1] 马苟平[1] 祝卫民[1] 

机构地区：[1]浙江省立同德医院骨科,浙江杭州310012 [2]桐乡市第一人民医院骨科,浙江桐乡314500

出　　处：《中国骨伤》2013年第3期214-217,共4页China Journal of Orthopaedics and Traumatology

基　　金：浙江省中医药科技计划(编号:2009-CA027)~~

摘　　要：目的:研究C形臂X线引导下针刀切断脊神经后内侧支治疗治疗腰椎关节突骨关节炎引起的腰痛的临床疗效。方法:自2009年7月至2011年6月治疗腰椎关节突骨关节炎的下腰痛患者60例,年龄39～73岁,平均61.9岁;病史6～120个月,平均18.9个月。将患者分为两组,30例采用C形臂X线引导下针刀切断脊神经后内侧支治疗(针刀组),30例采用C形臂X线引导下腰椎关节突关节局部封闭治疗(局封组),对所有患者在治疗前及治疗后1、12、26周进行JOA评分。结果:治疗前两组患者JOA评分差异无统计学意义(P=0.479);治疗后1周两组患者的JOA评分差异有统计学意义(P=0.040),且局封组的改善率优于针刀组,其中针刀组(58.73±18.20)%,局封组(71.10±22.19)%;治疗12周后两组患者的JOA评分差异无统计学意义(P=0.569),两组的改善率差异无统计学意义,其中针刀组(50.09±19.33)%,局封组(48.70±18.36)%);治疗26周后两组患者的JOA评分差异有统计学意义(P=0.000),且针刀组的改善率优于局封组,其中针刀组(48.56±28.24)%,局封组(15.62±11.23)%。结论:针刀切断脊神经后内侧支比腰椎关节突关节局部封闭治疗腰椎关节突骨关节炎具有更远期的疗效。Objective： To study the clinical efficacy of needle-knife to cut off the medial branch of the lumbar posterior ra- mus under C- arm guiding to treat low back pain caused by lumbar facet osteoarthritis. Methods：From July 2009 to June 2011,60 patients with low back pain caused by lumbar facet osteoarthritis were reviewed,including 34 males and 26 females, ranging in age from 39 to 73 years old, averaged 61.9 years old; the duration of the disease ranged from 6 to 120 months, with a mean of 18.9 months. All the patients were divided into two groups, 30 patients （ 18 males and 12 females, ranging in age from 39 to 71 years old, needle-knife group） were treated with needle-knife to cut off medial branch of the lumbar posterior ramus under C -arm guiding and the other 30 patients （ 16 males and 14 females, ranging in age from 41 to 73 years old, hormone injection group ） were treated with hormone injection in lumbar facet joint under C-arm guiding. The preoperative JOA scores and the scores at the Ist, 12th and 26th weeks after treatment were analyzed. Results： Before treatment, the JOA scores between the two groups had no significant difference （P= 0.479） ;after I week of treatment, the JOA scores between the two groups had significant difference （P= 0.040）, the improvement rate of hormone injection group was superior than that of the needle-knife group, which were （58.73± 18.20） % in needle-knife group and （71.10±22.19） % in hormone injection group ;after 12 weeks of treatment, the JOA scores be- tween the two groups had no significant difference （P=0.569）, and the improvement rate between the two groups had no significant difference ,which were （50.09±19.33）% in the needle-knife group and （48.70±18.36）%） in the hormone injection group; after 26 weeks of treatment, the JOA scores between the two groups had significant difference （P=0.000）, the improvement rate of hor- mone injection group was superior than that of the needle-knife group ,which were （48.56±28.24�

关 键 词：针刀 脊神经 骨关节炎 腰椎 病例对照研究 

分 类 号：R322.8[医药卫生—人体解剖和组织胚胎学]