微创重叠疗法治疗椎间盘源性腰痛的效果  

CLINICAL EFFECT OF MINIMALLY INVASIVE OVERLAPPING TREATMENT FOR DISCOGENIC LOW BACK PAIN

作　　者：牛选民 田晓冬 陈显业 张修塨 孙瑞府 汪学松 NIU Xuanmin;TIAN Xiaodong;CHEN Xianye;ZHANG Xiugong;SUN Ruifu;WANG Xuesong(Department of Orthopaedics, Qingdao Central Hospital, Qingdao 266042, Chin)

机构地区：[1]青岛市中心医院脊柱外科,山东青岛266042 [2]青岛市中心医院检验科,山东青岛266042

出　　处：《齐鲁医学杂志》2017年第5期577-579,583,共4页Medical Journal of Qilu

摘　　要：目的探讨采用射频热凝+臭氧椎间盘盘内消融、椎间孔臭氧消融与脊神经后支射频热凝+臭氧消融阻断术的重叠方法治疗椎间盘源性腰痛的临床效果。方法 2012年2月—2014年2月,对68例椎间盘源性腰痛病人行经皮穿刺微创重叠治疗。于末次随访时采用Nakano标准评价疗效;分别于术前和术后1、4、12周时采用Oswestry评分进行功能评估。结果手术时间20~40min,平均30min。术后随访6~18个月,平均14.8个月,未见手术相关并发症。末次随访时按Nakano标准评价疗效,优61例,良4例,可3例,差0例,优良率为95%。术后1、4、12周时Oswestry评分分别为(8.4±5.6)、(8.5±5.1)、(8.6±5.3)分,与术前(21.1±6.9)分相比,差异均有显著性(F=81.14,P<0.05)。结论采用经皮穿刺微创重叠技术治疗椎间盘源性腰痛近期效果满意。Objective To investigate the clinical effect of radiofrequency thermocoagulation＋ozone ablation of intervertebral disc,ozone ablation of intervertebral foramen,and radiofrequency thermocoagulation of the posterior ramus of spinal nerve＋ozone ablation occlusion in the treatment of discogenic low back pain.Methods A total of 68 patients with discogenic low back pain underwent minimally invasive percutaneous puncture and overlapping treatment from February 2012 to February 2014.The Nakano criteria were used to evaluate treatment outcome at the last follow-up visit;the Oswestry score was used for functional evaluation before surgery and at 1,4,and 12 weeks after surgery.Results The time of operation ranged from 20 to 40 minutes（mean 30 minutes）.The patients were followed up for 6-18 months（mean 14.8 months）,and no surgical complications were found.According to the Nakano criteria at the last follow-up visit,61 patients had an excellent outcome,4 had a good outcome,and 3 had a fair outcome,while no patient had a poor outcome,resulting in an excellent and good rate of 95%.There were significant changes in the Oswestry score at 1,4,and 12 weeks after surgery（8.4±5.6,8.5±5.1,8.6±5.3 vs 21.1±6.9 before surgery;F=81.14,P〈0.05）.Conclusion Minimally invasive percutaneous puncture and overlapping treatment have a satisfactory short-term clinical effect in the treatment of discogenic low back pain.

关 键 词：腰痛 椎间盘 外科手术 微创性 电凝术 臭氧 治疗结果 

分 类 号：R681.55[医药卫生—骨科学]