脊神经后内侧支射频毁损治疗慢性腰椎关节突关节源性腰痛的疗效  

Efficacy of radiofrequency thermocoagulation on posteromedian ramus of spinal nerve in the treatment of patients with chronic lumbar zygapophyseal joint pain

作　　者：杨小龙 张光志 黄恒 庞艳丽 周小军 

机构地区：[1]湖北省中山医院疼痛科,武汉市430000

出　　处：《实用疼痛学杂志》2015年第1期30-33,共4页Pain Clinic Journal

摘　　要：目的观察脊神经后内侧支射频毁损治疗关节突关节源性慢性腰痛的临床疗效。方法关节突关节源性慢性腰痛患者86例，在DSA引导下给予脊神经后内侧支射频毁损治疗，观察患者治疗前、治疗后1周、治疗后1年的VAS评分、ODI指数评分及治疗后疗效的优良率与不良反应。结果治疗后1周、1年的VAS评分、ODI指数评分均低于治疗前（P〈0．05）。治疗后1年的VAS与治疗后1周比较无统计学差异（P〉0．05），治疗后1年的ODI指数高于治疗后1周（P〈0．05），治疗后1周及1年的优良率分别为93．0％（80／86例）与75．0％（60／86例），治疗后1年的优良率低于治疗后1周（P〈0．05），未见明显的不良反应。结论脊神经后内侧支射频毁损治疗关节突关节源性慢性腰痛疗效肯定，且安全性高。Objective To evaluate the efficacy of radiofrequency thermocoagulation on posteromedian ramus of spinal nerve in the treatment of patients with chronic lumbar zygapophyseal joint pain. Methods A total of 86 patients with chronic lumbar zygapophyseal joint pain were treated with radiofrequency thermocoagulation on posteromedian ramus of spinal nerve under the guidance of digital subtraction angiography （DSA）. Visual analogue scale （VAS） and the Oswestry disability index （ODI） of the low back pain were recorded before the treatment and 1 week and 1 year after the treatment, and the effective rate and serious adverse reactions were also evaluated at 1 week and 1 year after the treatment. Results VAS and ODI at 1 week and 1 year after the treatment were significantly decreased compared with those before the treatment （P 〈 0.05）. There was no significant difference in VAS at 1 year and 1 week after the treatment （P 〉 0.05）, and ODI scores at 1 year were significantly increased compared with those at 1 week after the treatment （P 〈 0.05）. The excellent and good effective rate was 93.0% （80/86 cases） and 75.0% （60/86 cases） at 1 week and 1 year after the treatment respectively. The effective rate at 1 year after the treatment was significantly decreased compared with that at l week after the treatment （P 〈 0.05）. No serious adverse reactions were founded in all patients. Conclusion Radiofrequency thermocoagulation on posteromedian ramus of spinal nerve is an effective method for the treatment of patients with chronic lumbar zygapophyseal joint pain.

关 键 词：椎关节突关节 慢性病 腰痛 脊神经后内侧支 导管消融术 射频 热凝术 

分 类 号：R735.705[医药卫生—肿瘤]