摘要
目的研究C臂透视引导下注射型针刀经椎间孔外口松解治疗治疗腰椎间盘突出症的临床疗效。方法2015年1月~2017年6月治疗腰椎间盘突出症的患者90例(均为L_(4/5)、L_5/S_1单节段的椎间盘突出症患者),随机分为三组:注射型针刀组(30例)、单纯阻滞组(30例)和单纯针刀组(30例)。根据《日本骨科学会(JOA)腰痛疾患疗效评定标准》进行评分,对所有患者在治疗前、治疗后1周、1个月、6个月进行评分。结果治疗前三组患者的JOA评分无统计学差异(F=0.20,P=0.819)。与单纯阻滞组相比,注射型针刀组JOA评分在治疗后1周、治疗后1个月及治疗后6个月均有升高,差异有统计学意义(P<0.01)。与单纯针刀组相比,注射型针刀组JOA评分在治疗后1周、治疗后1个月及治疗后6个月均有升高,差异均有统计学意义(P<0.01)。治疗后1周单纯阻滞组JOA评分高于单纯针刀组(P<0.01)。治疗后1个月,单纯针刀组JOA评分高于单纯阻滞组(P=0.013)。治疗后6个月,单纯针刀组JOA评分高于单纯阻滞组(P<0.01)。三组患者治疗后并发症发生率无统计学差异(P>0.05)。结论采用C臂引导下注射型针刀经腰椎间孔神经阻滞及周围软组织松解治疗单节段腰椎间盘突出症比单纯阻滞治疗和单纯针刀治疗具有更好的近期及远期疗效。
Objective To study the clinical effect of C-arm fluoroscopy-guided injection needle knife in the treatment of lumbar disc herniation through the treatment of external transforaminal lysis. Methods 90 patients who received treatment of lumbar disc herniation from January 2015 to June 2017 （all patients with disc herniation in L4/5, L5/S1 single segmen0 were randomly divided into three groups： injection needle knife group （30 cases）, simple block group （30 cases） and simple needle knife group （30 cases）. According to the ＂Japan Orthopaedic Association （JOA） criteria for the evalu- ation of low back pain＂, all patients were scored before treatment, 1 week, 1 month, 1 month, and 6 months after treatment. Results The results showed no statistically significant difference in JOA scores between the three groups before treatment（F=0.20, P=0.819）. Compared with the simple block group, the JOA scores in the injection needle knife group were increased at 1 week after treatment（P〈0.01）, 1 month after treatment （P〈0.01）, and 6 months after treatment（P〈0.01）, and the difference was statistically significant. Compared with the simple needle knife group, the JOA scores in the injection type needle-knife group were increased at 1 week afler treatment（P〈0.01）, 1 month after treatment（P〈0.01）, and 6 months after treatment（P〈0.01）, and the difference was statistically significant. The JOA score in the simple block group was higher than that in the simple needle knife group at 1 week after treatment（P〈0.01）. The JOA score in the simple needle knife group was higher than that in the simple block group at 1 month after treatment（P=0.013）. The JOA score in the simple needle knife group was higher than that in the simple block group at 6 months after treatment（P〈0.01）. There was no statistically significant difference in the incidence rate of postoperative complications between the three groups. Conclusion The use of C-arm guided injection needle knife through lumbar intervertebral foramen nerve block and surrounding soft tissue lysis in the treatment of single-segment lumbar disc herniation has better short-term and long-term effects than simple block treatment and simple needle knife treatment.
作者
卢笛
丁伟国
许新伟
徐彬
徐卫星
LU Di;DING Weiguo;XU Xinwei;XU Bin;XU Weixing(Department of Orthopedics,Zhejiang Provincial Tongde Hospital,Hangzhou 310012,China)
出处
《中国现代医生》
2018年第27期58-62,69,共6页
China Modern Doctor
基金
浙江省中医药科学研究基金项目(2016ZB007)
浙江省科技计划公益技术应用研究项目(2017C33122)
关键词
C臂透视
联合治疗
针刀
经椎间孔注射
腰椎间盘突出症
C-arm fluoroscopy
Combined treatment
Needle knife
Transforaminal injection
Lumbar disc herniation
