射频消融术治疗腰脊神经后支卡压综合征的临床疗效观察  

Clinical efficacy of radiofrequency ablation in the treatment of lumbar spine nerve posterior branch entrapment syndrome

作　　者：叶豪 宋国平 王淑江 申小刚 秦黎勇 龙胜利 YE Hao;SONG Guo-ping;WANG Shu-jiang;SHEN Xiao-gang;QIN Li-yong;LONG Sheng-li(Traumatology College,Guizhou University of Traditional Chinese Medicine,Guiyang 550002,Guizhou,China;不详)

机构地区：[1]贵州中医药大学骨伤学院,贵州贵阳550002 [2]贵阳市第四人民医院疼痛康复科,贵州贵阳550007 [3]贵阳市第四人民医院脊柱外科,贵州贵阳550007

出　　处：《广东医学》2025年第2期228-232,共5页Guangdong Medical Journal

基　　金：贵州省中医药管理局中医药、民族医药科学技术研究课题(QZYY-2023-149)。

摘　　要：目的观察脊神经后支射频消融术治疗腰脊神经后支卡压综合征患者的有效性和安全性。方法选择疼痛科2021年10月至2023年12月期间收治的腰脊神经后支卡压综合征患者,根据手术方式的不同分为脊神经后支射频消融术(射频组)75例和脊神经后支神经阻滞术(阻滞组)75例。对患者按治疗周期时点1、3、6个月进行术后随访,利用视觉模拟评分法Visual Analog Scores(VAS)评价治疗前后疼痛评分、Oswestry功能障碍指数(ODI)评估腰椎功能、术后复发率及术后并发症情况。以最后一次随访为时间点,用MacNab评定标准评定治疗优良率及有效率。结果与术前相比,两组患者各时间点VAS评分、ODI指数均降低(P<0.05)。且射频组较阻滞组评分更低(P<0.05);治疗后两组临床疗效比较,射频组优良率及有效率均明显优于阻滞组(P<0.05);在安全性方面,射频组3、6个月复发率及总体复发率较阻滞组更低(P<0.05),在治疗过程中仅有3例患者出现术后局部肿胀或轻微疼痛[射频组1例、阻滞组2例(P>0.05)],术后2 d内缓解。结论对于腰脊神经后支卡压综合征引起疼痛,脊神经后支射频消融术能够有效的缓解疼痛,操作安全,不良反应少,值得临床推广。Objective To evaluate the efficacy and safety of radiofrequency ablation(RFA)in the treatment of lumbar spine nerve posterior branch entrapment syndrome.Methods A total of 150 patients diagnosed with lumbar spine nerve root compression syndrome were selected from the Pain Department between October 2021 and December 2023.Based on the type of surgery,the patients were divided into two groups:75 patients in the radiofrequency ablation group(RFA group)and 75 patients in the nerve block group(block group).Postoperative follow-up was conducted at 1,3,and 6 months after treatment.Pain severity was evaluated using the Visual Analog Scale(VAS),lumbar function was assessed using the Oswestry Disability Index(ODI),and recurrence rates and postoperative complications were monitored.At the final follow-up,clinical outcomes were assessed using the MacNab criteria to determine the excellent and effective rates.Results Compared with preoperative levels,both VAS scores and ODI indices significantly decreased at all follow-up time points in both groups(P<0.05).The RFA group had significantly lower scores than the block group(P<0.05).Regarding clinical efficacy,the excellent and effective rates were significantly higher in the RFA group than in the block group(P<0.05).In terms of safety,the recurrence rates at 3 and 6 months,as well as the overall recurrence rate,were significantly lower in the RFA group compared to the block group(P<0.05).Postoperative complications were minimal,with only 3 cases of mild local swelling or pain(1 in the RFA group and 2 in the block group;P>0.05),all of which resolved within 2 days.Conclusion Radiofrequency ablation is an effective and safe treatment for lumbar spine nerve root compression syndrome,significantly relieving pain with minimal side effects.This procedure has a high clinical efficacy and is worthy of further clinical promotion.

关 键 词：腰脊神经后支卡压综合征 脊神经后支 射频消融 神经阻滞 

分 类 号：R681.5[医药卫生—骨科学] R441.1[医药卫生—外科学]