射频消融髓核成形术治疗高龄腰椎间盘突出症的初步观察  

The primary clinical results of low temperature plasma radiofrequency ablation in treatment of elderly patients with lumbar disc herniation

作　　者：权学民[1] 张强[1] 赵昌松[1] 高峥嵘[1] 袁征[1] 李鑫[1] 刘琨[2] 王晶晶[3] 

机构地区：[1]首都医科大学附属北京地坛医院骨科,北京100015 [2]泰山医学院,山东泰安271000 [3]潍坊医学院,山东潍坊261000

出　　处：《颈腰痛杂志》2016年第1期47-50,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨低温等离子射频消融髓核成形术治疗高龄腰椎间盘突出症的可行性及临床疗效。方法2011-02—2014-03共收治18例高龄腰椎间盘突出症患者，男10例，女8例；年龄70-88岁，平均77．1岁；所有患者3个月以上非手术治疗无效，行低温等离子射频消融髓核成形术。术后随访采用VAS评分和患者满意度评价手术疗效。结果全部患者随访4-41个月，平均21个月。VAS评分术前（7．89±0．52）分，术后1周（2．89±0．46）分，末次随访（4．28±1．39）分，术后1周及末次随访时与术前比较差异有显著性（P〈0．01），术后1周与末次随访差异有统计学意义（P〈0．05）。1例术后症状改善不明显，4例术后6个月症状复发，但较术前减轻，患者满意度72．2％。结论低温等离子射频消融髓核成形术是治疗高龄腰椎间盘突出症的可行手段，特别在无法行开放手术的患者不失为一种选择，可以减轻疼痛，提高生活质量，保持长期疗效的关键是掌握患者适应证。Objective To evaluate the feasibility and clinical efficacy of low temperature plasma radiofrequency ablation in treatment of elderly patients with lumbar disc herniation. Methods From February 2011 to March 2014, 18 elderly patients with lumbar disc herniation were admitted （10 men, 8 women, ranged 70-88 years, average 77.1 years）. All patients＇ symptoms were not improved after conservative treatment for more than 3 months before surgery. VAS score and satisfaction were evaluated postoperatively. Results All patients were followed up for 4-41 months, average 21 months. Preoperative VAS score was （7.89±0.52）, one week after operation（2.89＋0.46）, the last follow-up（4.28±1.39）. One week post-operation and the last fol- low-up VAS sores were decreased significantly compared with pre-operation （P〈0.05）. There was significant difference between one week post-operation and the last follow-up （P〈0.05）. One patient＇s symptoms were not improved obviously. Four patients symptoms recurred after 6 months, but they were better than pre-operation. The degree of satisfaction in patients was 72.2%. Conclusion Coblation nucleoplasty is a feasible approach for elderly patients with lumbar disc herniation. Especially for patients who are unsuitable for invasive surgery, it may be a better option. It can relieve pain and improve the quality of life. However, appropriate indication is the key to keep well long-term efficacy.

关 键 词：低温等离子射频消融 髓核成形术 腰椎间盘突出 高龄 

分 类 号：R681.53[医药卫生—骨科学]