摘要
目的通过前瞻性分组对照研究,探讨脊神经后支射频热凝联合髓核减压手术治疗椎间盘源性下腰痛(discogenic lowback pain,DLBP)的临床疗效。方法自2013-01-2015-01,共纳入了80例DLBP患者,分别采用单纯髓核减压术治疗38例(对照组),脊神经后支射频热凝联合髓核减压术治疗42例(联合组),对两组患者手术前后的VAS、JOA评分及末次随访时的疗效进行对比。结果所有患者均获得12-26个月随访,平均19.8个月。术后各时间点的VAS、JOA评分,均较治疗前有显著性改善(P<0.05),但联合组的改善情况显著优于对照组(P<0.05);联合组总有效率为92.9%,显著高于对照组的81.6%,差异有统计学意义(P<0.05);联合组5例(11.9%)患者术后出现腰部的局部麻木感,对照组有3例(7.89%)由于穿刺针对脊神经的刺激,两组的并发症发生率无显著性差异(P>0.05)。结论利用脊神经后支射频热凝术联合微创髓核减压术治疗DLBP,其创伤小、疼痛改善效果更佳,术后功能恢复良好,有较高的安全性,值得推广应用。
Objective To investigate the clinical efficacy of radiofrequency thermocoagulation combined with nucleus pulposus decompression in the treatment of discogenic low back pain （DLBP） by means of a prospective group controlled study. Methods From JanuaPy 2013 to January 2015, 80 DLBP patients were selected. 38 cases in the control group were treated with single nucleus pulposus decompression, 42 cases in the combined group were treated with radiofrequency thermocoagulation combined with nucleus pulposus decompression. Before and after surgery, the JOA score and VAS, the efficacy at the end of the follow-up were compared between the two groups. Results All patients were followed up for 12-26 months with an average of 19.8 months. At each time point after operation, the VAS and JOA score were significantly improved （P〈0.05）, but the improvement of the combination group was significantly better than the control group （P〈0.05）. The total effective rate of the combined group was 92.9%, which was significantly higher than 81.6% of the control group, the difference was statistically significant （/）〈0.05）. In terms of security, in combined group, 5 cases （11.9%） had postoperative numbness waist, 3 cases in the control group （7.89%） as the needle in spinal nerve stimulation, complications of the two groups had no significant difference （P〉0.05）. Conclusion The posterior branch of spinal nerve radiofrequency thermoeoagulation combined with minimally invasive nucleus pulposus decompression in the treatment of DLBP has small trauma, better pain improvement effect, good postoperative functional recovery, high safety, which is worthy of clinical application.
出处
《颈腰痛杂志》
2017年第6期579-582,共4页
The Journal of Cervicodynia and Lumbodynia
关键词
椎间盘源性下腰痛
脊神经后支
射频热凝
髓核减压手术
discogenic low back pain
posterior branch of spinal nerve
radiofrequency thermocoagulation
nucleus pulposus decompression
