摘要
目的探讨选择性神经根阻滞联合椎间孔镜治疗老年多节段腰椎管狭窄症的疗效。方法采用选择性神经根阻滞联合椎间孔镜治疗30例老年多节段腰椎管狭窄症患者。记录阻滞术及椎间孔镜手术前后疼痛VAS评分及JOA评分。采用Nakai分级标准评价疗效。结果患者均获得随访,时间13~28(17.2±3.9)个月。阻滞术后,VAS评分较术前降低,JOA评分较术前提高,差异均有统计学意义(P<0.01)。椎间孔镜术后3个月及术后1年JOA评分和VAS评分均较术前明显改善(P<0.01)。术后1年根据Nakai分级标准评价疗效:优16例,良10例,可4例,优良率为26/30。结论选择性神经根造影能有效确认责任神经根及责任节段,神经根阻滞结合椎间孔镜技术解除神经根压迫,可显著改善腰椎管狭窄症症状,提高患者生活质量。
Objective To investigate the efficacy of selective nerve root block(SNRB)combined with transforaminal endoscopic in the treatment of multi-segment lumbar stenosis in the elderly.Methods The 30 patients with lumbar multi-segmental lumbar stenosis were treated with SNRB combined with transforaminal endoscopic discectomy.JOA scores and visual analogue scale(VAS)of lumbar pain before and after surgery were recorded.Nakai grading criterion was used to evaluate the efficacy.Results All patients were followed up for 13~28(17.2±3.9)months.After nerve root block surgery,the VAS were decreased than the preoperation,and JOA scores were increased than the preopeation,there were statistical differences(P<0.01);at 3 months and 1 year after transforaminal endoscopic surgery,both of JOA socres and VAS were significantly improved than the preopeation(P<0.01).At 1 year postoperation,the efficacy was evaluated according to the Nakai grading standard:excellent in 16 cases,good 10 cases,fair 4,with the excellent-good rate of 26/30.Conclusions Selective nerve root radiography is an effective method for identifying the responsible segment,nerve root block combined with percutaneous transforaminal endoscopic discectomy can relieve the decompress of the responsible nerve root,and significantly improve the symptom of lumbar stenosis,improve the quality of patient′s life.
作者
陆惠根
胡旭琪
潘学康
陈宝
周晓
俞叶峰
戴加平
陈刚
LU Hui-gen;HU Xu-qi;PAN Xue-kang;CHEN Bao;ZHOU Xiao;YU Ye-feng;DAI Jia-ping;CHEN Gang(Dept of Orthopaedics,the Second Hospital of Jiaxing City,Jiaxing, Zhejiang 314000,China)
出处
《临床骨科杂志》
2021年第5期622-625,共4页
Journal of Clinical Orthopaedics
基金
浙江省嘉兴市科技局科技计划项目(编号:2017AY33028)
浙江省卫计委医药卫生学科平台项目(编号:2018RC074,2020KY957)。
关键词
选择性神经根阻滞
椎间孔镜
多节段腰椎管狭窄
selective nerve root block
intervertebral foramina
multi-segment lumbar stenosis
