射频消融髓核成形术治疗神经根型颈椎病的临床效果观察  

Observation of clinical effects of radiofrequency ablation in the treatment of cervical spondylotic radiculopathy

作　　者：张学伟 李士春 Zhang Xuewei Li Shichun(Department of Orthopedics, Shijingshan Teaching Hospital Affiliated to Capital Medical University, Beijing 100043, China)

机构地区：[1]首都医科大学石景山教学医院 北京市石景山医院骨科,100043

出　　处：《中国综合临床》2017年第8期734-737,共4页Clinical Medicine of China

摘　　要：目的 比较保守治疗与射频消融髓核成形术治疗神经根型颈椎病的临床效果,分析其原因及探讨手术适应证.方法 选取2013年5月至2016年5月我院收治的神经根型颈椎病患者55例作为观察对象,其中保守治疗30例（保守组）,应用射频消融髓核成形手术治疗25例（手术组）.在治疗后1周、1个月采用视觉模拟评分（VAS）评估比较两组患者治疗前后疼痛缓解情况.观察两组患者药物的副作用及手术患者术后的并发症发生情况.结果 手术组与保守组在治疗后1周VAS评分（3.2±0.5）分,（5.2±0.7））分、1个月（2.8±0.3）,（5.8±0.4）分时疼痛程度较治疗前（8.0±0.9）分,（7.6±0.8）分均有缓解,差异有统计学意义（P均〈0.05）,且手术组较保守组缓解程度更为明显,两组比较差异有统计学意义（P均〈0.01）.两组患者使用药物治疗无明显不适.手术组患者手术顺利,未出现神经及脊髓损伤、血管损伤、局部血肿、穿刺针断裂及椎间隙感染等并发症.结论 射频消融髓核成形术治疗神经根型颈椎病在短期内缓解疼痛较保守治疗更有效,对于无明显手术禁忌的患者建议选用手术治疗.Objective To compare the clinical effects of conservative therapy and radiofrequency ablation in the treatment of cervical spondylotic radiculopathy,to analyze the reason and discuss the surgical indications.Methods Fifty-five patients with cervical spondylotic radiculopathy treated in Shijingshan Hospital from May 2013 to May 2016 were selected and retrospectively analyzed,including 30 patients received conservative treatment （conservative group）,25 patients undergone radiofrequency ablation （operation group）.Visual analogue score （VAS） was used to assess the degree of pain relief in the two groups before treatment and 1 week,1 month after treatment.The side effects in the two groups and the postoperative complications of the patients were observed.Results The VAS score of the operation group and the conservative group in 1 weeks after treatment were （3.2±0.5） points,（5.2±0.7）） points,1 months （2.8±0.3） points,（5.8±0.4） points,respectively,the degree of pain were lower than those collected before treatment （8.0±0.9） points,（7.6±0.8） points,separately,the differences were statistically significant （P〈0.05）,and the degree of pain relief in the operation group was more obvious than that in the conservative group,there was significant difference between the two groups （P〈0.01）.Two groups of patients were treated with medication without any obvious discomfort.The surgery of the operation group was successful,and no complications such as nerve and spinal cord injury,vascular injury,local hematoma,puncture needle breakage and intervertebral space infection were found.Conclusion Radiofrequency ablation is more effective for the treatment of cervical spondylotic myelopathy in the short term than conservative treatment,and radiofrequency ablation treatment is a recommended choice for patients with no surgical contradiction.

关 键 词：神经根型颈椎病 微创 射频消融术 

分 类 号：R687.3[医药卫生—骨科学]