射频消融联合自体富血小板血浆注射对腰椎间盘源性腰痛的早期疗效研究  

Early outcomes of radiofrequency ablation combined with autologous platelet-rich plasma injection in discogenic low back pain

作　　者：韦家冬 方剑明 冯冠成 江思达 林琛 俞兵兵 吕浩然[1] 张东升 Wei Jiadong;Fang Jianming;Feng Guancheng;Jiang Sida;Lin Chen;Yu Bingbing;Lyu Haoran;Zhang Dongsheng(Department of Spine Surgery,Fifth Affiliated Hospital of Guangzhou Medical University,Guangzhou 510735,China)

机构地区：[1]广州医科大学附属第五医院脊柱外科,广州510735

出　　处：《中华生物医学工程杂志》2022年第3期311-316,共6页Chinese Journal of Biomedical Engineering

摘　　要：目的比较射频消融联合自体富血小板血浆注射与射频消融治疗椎间盘源性腰痛的早期临床疗效。方法选取自2018年5月至2021年2月广州医科大学附属第五医院骨科收治的48例腰椎间盘源性腰痛患者为研究对象。按照随机数字表法分为消融组(n=20)和消注组(n=28)。消融组采用在C臂机引导下行经皮穿刺低温等离子射频消融治疗, 消注组在射频消融基础上接受富血小板血浆注射, 评估并记录两组患者不同时间点的疼痛[视觉模拟评分法(VAS)]、腰椎功能[Oswestry功能障碍指数(ODI)]以及术后末次随访临床疗效(改良Macnab标准)。结果两组患者在术后第1天、第1个月、第3个月、第6个月的VAS评分及ODI评分均低于术前(P<0.05), 消注组在术后在术后第1天、第1个月、第3个月、第6个月的VAS评分及ODI评分低于消融组, 差异均有统计学意义(P<0.05)。比较两组的术后末次随访临床疗效, 消注组优于消融组, 差异有统计学意义(P<0.05)。结论射频消融术可显著改善腰椎间盘源性腰痛患者的疼痛及腰椎功能, 椎间盘内注射自体富血小板血浆可提高临床疗效, 安全性较好。Objective To compare the early clinical outcomes of radiofrequency ablation combined with autologous platelet-rich plasma injection vs radiofrequency ablation alone in the treatment of discogenic low back pain.Methods Included in this study were 48 patients with discogenic low back pain admitted to the Department of Orthopedics of Fifth Affiliated Hospital,Guangzhou Medical University,between May 2018 and February 2021.According to random number table,the subjects were divided into the ablation-alone group(n=20)and ablation-injection group(n=28).The ablation-alone group underwent percutaneous low-temperature plasma radiofrequency ablation under C-arm X-ray guidance.In addition to these,the patients in the ablation-injection group received platelet-rich plasma injection.The two groups were recorded and evaluated for pain severity[by visual analog scale(VAS)]and lumbar spinal function[by Oswestry Disability Index(ODI)]at different time points,as well as the clinical outcome at the last follow-up after surgery(by modified Macnab criteria).Results The VAS and ODI scores on day 1,and in the first,third and sixth months after surgery were lower in patients of the either group compared with baseline(P<0.05),and were also lower in patients of the ablation-injection group compared with those of the ablation-alone group,with statistically significant differences(P<0.05).At the last follow-up,the clinical outcome was more favorable in the ablation-injection group compared with the ablation-alone group,with statistically significant difference(P<0.05).Conclusion Radiofrequency ablation may significantly improve the pain severity and lumbar spinal function in patients with discogenic low back pain.Intradiscal injection of autologous platelet-rich plasma may further improve the clinical outcomes with good safety.

关 键 词：射频消融 椎间盘源性腰痛 自体富血小板血浆 椎间盘退变 

分 类 号：R681.53[医药卫生—骨科学]