射频消融结合针刀松解治疗腰椎手术失败综合征  

Clinical effect of the radiofrequency ablation combined with the acupotome release in the treatment of the failed back surgery syndrome

作　　者：孙长乐 张荣宜 SUN Changle;ZHANG Rongyi(Department of Pain,Fuyang People’s Hospital,Fuyang 236000,China;Department of Pain,First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽省阜阳市人民医院疼痛科,安徽阜阳236000 [2]安徽医科大学第一附属医院疼痛科,合肥230022

出　　处：《长春中医药大学学报》2022年第5期548-551,共4页Journal of Changchun University of Chinese Medicine

基　　金：安徽省自然科学基金(1808085MH310)。

摘　　要：目的探讨射频消融结合针刀松解治疗腰椎手术失败综合征的临床疗效。方法42例腰椎手术失败综合征患者按首次手术术前诊断分为椎间盘突出组与椎管狭窄组,经射频消融结合针刀松解治疗,随访3个月、6个月、12个月,观察各组视觉模拟评分(VAS)各时间节点变化情况,分析2组临床疗效。结果2组术后VAS评分较术前降低(P<0.05),患者术后6个月VAS评分显著降低,术后1年VAS评分较术前降低(P<0.05)。椎间盘突出组有效率高于椎管狭窄组,2次以上手术者有效率降低。无不良反应及并发症。结论射频消融结合针刀松解治疗腰椎术后疼痛综合征,需辩因治疗,对术后再突出者效果较好,对于椎管狭窄及瘢痕黏连者效果较差,单次术后者效果较好,多次术后者效果较差,远期疗效有待进一步观察。Objective To investigate the clinical effect of the radiofrequency ablation combined with the acupotome release in the treatment of the failed back surgery syndrome.Methods A total of forty-two patients with the failed back surgery syndrome were divided into an intervertebral disc herniation group and a spinal stenosis group according to the first preoperative diagnosis.They were treated with the radiofrequency ablation combined with the acupotome release and followed up for 3 months,6 months and 12 months.The score changes of visual analogue scale(VAS)at each time point in each group were observed,and the clinical efficacy of the two groups was analyzed.Results The postoperative VAS scores of the two groups were decreased than before surgery(P<0.05),while significantly lower 6 months after surgery,and lower one year after surgery(P<0.05).The effective rate of the intervertebral disc herniation group was higher than that of the spinal stenosis group,and the effective rate of patients with more than two operations was lower,while there were no adverse reactions and complications.Conclusion The radiofrequency ablation combined with the acupotome release in the treatment of the postoperative back pain syndrome needs conducting on the basis of its etiology differentiation.It has a good effect on patients with a postoperative re-protrusion,but a poor effect on patients with a spinal stenosis and scar adhesion,and a good effect on patients with a single operation,while a poor effect on patients with multiple operations,yet its long-term efficacy needs to be further observed.

关 键 词：射频消融 针刀 腰椎手术失败综合征 

分 类 号：R49[医药卫生—康复医学]