射频电热成形术联合臭氧治疗盘源性腰痛

发布时间：2019-04-18 15:24

【摘要】：目的探讨椎间盘纤维环射频电热成形术联合臭氧治疗慢性盘源性腰痛(discogenic low back pain,DLBP)的临床效果及安全性。方法 2013年6月~2015年6月采用椎间盘纤维环射频电热成形术联合椎间盘内臭氧注射治疗60例慢性DLBP,采用汉化Oswestry功能障碍指数法(Chinese version Oswestry disability index,CODI)、视觉模拟评分(visual anologue scale,VAS)评价术前后患者功能状态、疼痛情况。结果无严重并发症发生。治疗后两节段患者VAS评分从术前1 d(7.4±1.2)分降到术后7 d(1.7±0.4)分(q=57.647,P0.05)、术后15 d(1.3±0.3)分(q=61.692,P0.05)、术后1个月(1.1±0.4)分(q=63.715,P0.05)、术后3个月(0.9±0.3)分(q=65.738,P0.05)、术后6个月(0.8±0.4)分(q=66.749,P0.05)、术后1年(0.8±0.3)分(q=66.749,P0.05),能维持12个月以上;术后CODI优良率80%以上,CODI术前1 d与术后各时点均有统计学差异(P0.05)。单节段患者VAS评分从术前1 d(7.6±1.1)分降到术后7 d(1.8±0.3)分(q=60.628,P0.05)、术后15 d(1.2±0.4)分(q=66.900,P0.05)、术后1个月(0.9±0.5)分(q=70.036,P0.05)、术后3个月(0.8±0.3)分(q=71.081,P0.05)、术后6个月(0.7±0.4)分(q=77.127,P0.05)、术后1年(0.8±0.3)分(q=71.081,P0.05),并能维持12个月以上;术后CODI优良率78%以上,CODI术前1 d与术后各时点均有统计学差异(P0.05)。结论椎间盘纤维环射频电热凝疗法能使损伤椎间盘发生再塑形,修复损伤椎间盘,快速缓解患者疼痛,显著改善患者功能状态,并发症少,是治疗盘源性腰痛的一种安全有效的方法。
[Abstract]:Objective to evaluate the clinical effect and safety of disc annulus electrothermal arthroplasty combined with ozone in the treatment of chronic discogenic low back pain (discogenic low back pain,DLBP). Methods from June 2013 to June 2015, 60 patients with chronic DLBP, were treated with fiberoptic ring electrothermal arthroplasty combined with intradiscal ozone injection. The Chinese Oswestry dysfunction index (Chinese version Oswestry disability index,CODI) and visual analogue score (visual anologue scale,) were used to treat 60 patients with chronic (Chinese version Oswestry disability index,CODI. VAS) evaluated the patients' functional status and pain before and after the operation. Results there were no serious complications. After treatment, the VAS score decreased from (7.4 卤1.2) to (1.7 卤0.4) on the 1st day before operation to (1.7 卤0.4) on the 7th day after treatment, and (1.3 卤0.3) on the 15th day after the operation (Q = 61.692, P0.05), and decreased from 1 day before the operation to (1.7 卤0.4) on the 7th day after the operation (Q = 57.647, P 0.05). The scores were (1.1 卤0.4) at 1 month after operation (Q = 63.715, P 0.05), (0.9 卤0.3) at 3 months (Q = 65.738, P 0.05), and (0.8 卤0.4) at 6 months (Q = 66.749, P 0.05), respectively. One year after operation, the score of (0.8 卤0.3) (Q = 66.749, P0.05) could be maintained for more than 12 months. The excellent and good rate of CODI after operation was more than 80%. There was statistical difference between the postoperative time point and the preoperative day of CODI (P0.05). The VAS scores of single segment patients decreased from (7.6 卤1.1) to (1.8 卤0.3) on the 1st day after operation, (60.628, P0.05) on the 7th day after operation, and (1.2 卤0.4) on the 15th day after the operation (Q = 66.900, P0.05). One month after operation (0. 9 卤0. 5, P0.05), three months after operation (0. 8 卤0. 31, P 0.05), six months after operation (0. 7 卤0. 4) (Q = 77. 127, P 0.05), the score was (0. 8 卤0. 3) at 3 months after operation (Q = 71. 081, P 0. 05). One year after operation, the score was (0.8 卤0.3) (Q = 71.081, P0.05) and could be maintained for more than 12 months. The excellent and good rate of CODI after operation was more than 78%. There was statistical difference between the preoperative and postoperative time points of CODI (P0.05). Conclusion Intervertebral disc fiber ring electrocoagulation therapy can make the injured intervertebral disc reform, repair the injured intervertebral disc, relieve the pain of the patients quickly, improve the function of the patients, and reduce the complications. It is a safe and effective method to treat discogenic low back pain.
【作者单位】：西安交通大学第一附属医院疼痛科;
【分类号】：R687.3

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