摘要
目的评估CT介导下后入路经椎管及硬膜囊椎间盘内医用臭氧精确注射治疗腰椎问盘突出症的疗效及优势。方法 262例腰椎间盘突出症患者于CT介导下从背部棘突旁开约1～2 cm后入路经椎管及硬膜囊穿刺到达椎间盘内,臭氧注射靶点为椎问盘、突出髓核及患侧硬膜外间隙神经根周围。椎间盘及突出髓核内医用臭氧浓度40～50μg/ml,神经根旁医用臭氧浓度30μg/ml。结果所有患者治疗成功。术前平均JOA评分为(8.30±1.40)分,下肢根性痛VAS评分平均为(8.73±0.80)分;术后3月随访JOA评分平均为(24.16±3.20)分,下肢根性痛VAS评分平均为(2.41±0.20)分;术前及术后JOA评分和VAS评分均存在显著差异(P值分别0.0158和0.0242)。按照改良的MacNab分级法,165例患者达到优,64例达到良,可20例,差13例,总优良率达87.4%。全部患者均未见任何严重并发症。结论 CT介导下后入路经椎管及硬膜囊腰椎间盘内医用臭氧注射能够达到精确的靶点注射,手术安全,可以提高治疗腰椎间盘突出症的效果。
Objective To evaluate the effect of targeted percutaneous injection of medical ozone through the posterior approach via the spinal canal and dural sac under CT guidance for treatment of lumbar disc herniation.Methods In 262 patients with lumbar disc herniation,medical ozone was injected percutaneously under CT guidance into the lumbar intervertebral disc by the posterior approach at paramedian 1-2 cm from the spinous process,targeting the affected lumbar discs,protruded nucleus pulposus and ipsilateral lateral recess.The concentration of ozone was 40-50μg/ml in the disc/protruded nucleus pulposus and 30μg/ml in the lateral recess（around the nerve root）.Results The treatment procedures were successfully completed in all the 262 patients.The average scores of JOA and VAS before treatment were 8.30±1.4 and 8.73±0.8,and changed significantly to 24.16±3.2（P=0.0158） and 2.41±0.2（P=0.0242） after treatment,respectively.According to the modified MacNab criteria,the therapeutic effect was excellent in 165 cases,fair in 64 cases,acceptable in 20 cases,and poor in 13 cases,with a total success rate of 87.4%.No patient showed serious complications after the treatment.Conclusion Compared with routine ozone therapy by the posterior-lateral approach,targeted percutaneous ozone injection into the intervertebral disc by the modified posterior approach is safe and yields better therapeutic effect for lumbar disc herniation.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2012年第2期243-246,共4页
Journal of Southern Medical University
基金
广东省医学科学技术基金(2011063)
