内窥镜下脊神经背内侧支切断术治疗腰椎小关节综合征的临床疗效分析  

The clinical efficacy of endoscopic dorsal medial branch rhizotomy for the lumbar facet syndrome

作　　者：杨国强[1] 郭岩凤[1] 

机构地区：[1]首都医科大学密云教学医院骨一科,北京101500

出　　处：《颈腰痛杂志》2016年第5期380-383,共4页The Journal of Cervicodynia and Lumbodynia

基　　金：首都医学发展科研基金(编号:2009-32690)

摘　　要：目的探讨内窥镜下脊神经背内侧支切断术治疗腰椎小关节综合征的临床疗效。方法选择2012-08-2015-03我院诊治的腰椎小关节综合征患者78例,根据随机抽签原则分为观察组与对照组各39例,对照组给予局部封闭保守治疗,观察组给予内窥镜下脊神经背内侧支切断术治疗。结果所有患者均完成治疗,观察组术中见脊神经背内侧支存在多种变异;经过评定,两组治疗后1 d和3个月的疼痛评分均明显低于治疗前(P<0.05),同时观察组治疗后3个月的疼痛评分也明显低于对照组(P>0.05)。观察组治疗3个月内的神经根损伤、皮肤感觉功能缺失、疼痛性感觉迟钝、肺部感染等并发症发生情况明显少于对照组(P<0.05)。治疗3个月后,观察组的优良率为94.9%,对照组为76.9%,观察组的优良率明显高于对照组(P<0.05)。结论内窥镜下脊神经背内侧支切断术治疗腰椎小关节综合征,有明显的镇痛效果,术后并发症少。Objective To discuss the clinical efficacy of endoscopic dorsal medial branch rhizotomy for the lumbar facet Syndrome. Methods From August 2012 to March 2015, 78 patients with lumbar facet syndrome in our hospital were randomly divided into observation group and control group, 39 patients in each group. The control group received conservative treatment of partial closure, the observation group received endoscopic dorsal medial branch rhizotomy treatment. Results All patients completed the treatment, and the observation group intraoperation were seen the dorsal medial branch with many variation. After evaluation, the postoperative 1 day and 3 months pain scores were significantly lower than preoperation （P〈0.05）, while the postoperative 3 months pain scores in the observation group were significantly lower than the control group （P〉0.05）. The postoperative 3 months nerve root injury, skin feeling deficits, painful sensation, lung infections and other complications in the observation group were significantly less than the control group （P〈0.05）. The postoperative 3 months excellent rate in the observation group was 94.9%, which was significantly higher than 76.9% of the control group （P〈0.05）. Conclusion Endoscopic dorsal medial branch rhizotomy for the lumbar facet syndrome can play more effective analgesic effect, it can reduce the incidence of postoperative complications and improve the overall therapeutic effect.

关 键 词：内窥镜 脊神经背内侧支切断术 腰椎小关节综合征 疼痛 并发症 

分 类 号：R681.55[医药卫生—骨科学]