摘要
目的比较两种微创手术方式治疗椎间盘源性腰痛(DLBP)的临床疗效。方法DLBP患者68例随机均分为两组,分别采用射频热凝联合臭氧治疗(A组)和椎间孔镜下髓核摘除联合射频热凝纤维环成形术(B组),比较两组患者术前及术后即刻、3d、1个月的VAS疼痛评分和日本骨科协会(JOA)评分,随访术后3、6、12和18个月时的复发率。结果 A组手术时间及术中出血量均低于B组(P<0.01)。两组术后VAS和JOA评分均优于术前(P<0.01),A组术后即刻和术后3d的VAS疼痛和JOA评分均优于B组(P<0.01)。随访3个月时,两组均无复发病例;A组随访6、12和18个月时的复发率高于B组(P<0.05)。结论两种微创手术方法治疗DLBP均能取得良好近期疗效。与椎间孔镜下髓核摘除联合射频热凝纤维环成形术比较,射频热凝联合臭氧治疗DLBP手术时间短,术中出血量少,但远期复发率较高。
Objective To compare the clinical efficacy of two minimally invasive surgical methods in the treatment of discogenic low back pain（DLBP）.Methods Sixty-eight patients with DLBP were randomly and equally divided into two groups.The patients in group A were treated with radiofrequency thermocoagulation combined with ozone and those in group B were treated with intervertebral disc nucleus pulposus combined with radiofrequency thermocoagulation annuloplasty.The scores of VAS pain and JOA were evaluated before and immediately after operation and on the 3^rd and in the 1^st month after operation.The recurrence rates in the 3^rd,6^th,12^th and 18^th month during follow-up were compared between two groups.Results The operation time and intraoperative blood loss were lower in group A than those in group B（P〈0.01）.The scores of VAS pain and JOA were significantly improved after operation than those before in both groups（P〈0.01）,which were also improved immediately and at the 3～rd day after operation in group A than those in group B（P〈0.01）.There was no recurrent case within 3 month after operation in both groups.The recurrence rates in the 6^th,12^th and 18^th month during follow-up were higher in group A than those in group B（P〈0.05）.Conclusion The two surgical methods above can produce a good short-term clinical efficacy in treating DLBP.Compared to intervertebral disc nucleus pulposus combined with radiofrequency thermocoagulation annuloplasty,radiofrequency thermocoagulation combined with ozone has the advantages of shorter operation time and less blood loss,but higher recurrence rates in the long-term follow-up.
作者
钟远鸣
张翼升
李嘉琅
陈震
ZHONG Yuanming;ZHANG Yisheng;LI Jialang(Department of Spine Surgery, First Affiliated Hospital, Guangxi University of Traditional Chinese Medicine, Nanning 530023, CHIN)
出处
《江苏医药》
CAS
2018年第6期664-667,共4页
Jiangsu Medical Journal
基金
国家自然科学基金(81760874)
关键词
射频热凝
椎间孔镜
椎间盘源性腰痛
Radiofrequency thermocoagulation
Intervertebral mirror
Discogenic low back pain
