椎间盘内射频电刺激定位椎间盘源性腰痛责任椎间盘  

Location of responsible intervertebral disc with radiofrequency electrical stimulation for lumbar discogenic pain

作　　者：唐元章[1] 郭玉娜[1] 孙晨力 魏亚 倪家骧[1] TANG Yuanzhang;GUO Yuna;SUN Chenli;WEI Ya;NI Jiaxiang(Department of Pain Management,Xuanwu Hospital,Capital MedicalUniversity,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院疼痛科,北京100053

出　　处：《中国介入影像与治疗学》2018年第8期469-472,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：北京市医管局"青苗计划"(QML20160807);北京市医院管理局临床医学发展专项经费(ZYLX201507)

摘　　要：目的探讨椎间盘内射频电刺激定位椎间盘源性腰痛责任椎间盘的有效性。方法对78例椎间盘源性腰痛患者,在CT引导下通过椎间盘内射频电刺激定位责任椎间盘,根据椎间盘电刺激诱发试验结果分为A组(椎间盘电刺激试验诱发阳性)及B组(椎间盘电刺激试验诱发阴性)。行椎间盘低温等离子纤维环成形术。以疼痛数字评分法(NRS)评价患者疼痛程度,以改良MacNab评分评价术后患者主观满意度,并进行统计学分析。结果 78例中,A组67例,B组11例。2组患者术前NRS评分差异无统计学意义(P>0.05),A组术后1周、1个月及6个月NRS评分均较B组减低(P均<0.05)。术后1、3、6个月,A组患者MacNab评分优良率均明显高于B组(P均<0.05)。术后无严重并发症发生,仅6例出现穿刺点皮下淤血、14例穿刺点局部疼痛,均在术后2周内自行消失。结论椎间盘电刺激诱发试验阳性患者椎间盘低温等离子纤维环成形术后疼痛缓解程度和患者主观满意度更优;椎间盘内射频电刺激有助于准确定位椎间盘源性腰痛责任椎间盘。Objective To explore the effect of responsible intervertebral disc location with radiofrequency electrical stimulation in patients with lumbar discogenic pain.Methods A total of 78 patients with lumbar discogenic pain were enrolled.All patients underwent location of responsible intervertebral disc with CT-guided radiofrequency electrical stimulation.According to the results of electrical stimulation test,the patients were divided into group A（positive electrical stimulation）and group B（negative electrical stimulation）.Coblation annuloplasty procedure of intervertebral disc was performed on all patients.Numerical rating scale（NRS）and modified MacNab scale were used for evaluating intraoperative pain and patient＇s satisfaction.Then statistical analysis was performed.Results There were 67 patients in group A and 11 patients in group B.No statistical difference of NRS was found between the 2 groups before operation.NRSs in group A decreased compared with those in group B 1 week,1 month and 6 months after coblation annuloplasty（all P〈0.05）.Furthermore,the rate of excellent and good results according MacNab score in group A were higher than those in group B on 1 week,1 month,3 months and 6 months after coblation annuloplasty（all P〈0.05）.No serious complication occurred.Subcutaneous ecchymosis was noticed in 6 patients,and local pain at puncture point occurred in 14 patients,but all disappeared within 2 weeks.Conclusion Patients with positive electrical stimulation may acquire better pain relief and satisfaction after coblation annuloplasty,indicating that disc electrical stimulation may be an effective method to location responsible disc for lumbar discogenic pain.

关 键 词：椎间盘 疼痛 等离子纤维环成形术 电刺激 

分 类 号：R684[医药卫生—骨科学] R815[医药卫生—外科学]