低温等离子髓核减压术对神经根型颈椎病的疗效及其与弧弦距的相关性

Efficacy of temperature-controlled plasma radiofrequency ablation against nervous root type cervical spondylosis and its correlation with string-arcing distance

目的探讨低温等离子髓核减压术治疗神经根型颈椎病患者的疗效及其与弧弦距的相关性。方法选择2018-11至2019-07在北京中医药大学东直门医院骨科诊断为神经根型颈椎病的住院患者34例,测量其弧弦距数值,采用经皮穿刺低温等离子髓核减压术治疗,评定治疗效果采用疼痛视觉模拟(VAS)评分、颈椎功能障碍指数(NDI)评分的方法量化,于术前1 d、术后1周、术后1个月由患者填写自身情况。结果(1)在术前1 d、术后1周、术后1个月VAS评分分别为(7.21±0.687)分、(3.12±1.225)分、(1.94±1.278)分。NDI评分分别为(15.79±2.185)分、(7.85±2.476)分、(6.12±3.003)分,术后1周VAS评分、NDI评分均较治疗前降低,差异有统计学意义(P<0.01),术后1个月VAS评分、NDI评分较术后1周降低,差异有统计学意义(P<0.01)。弧弦距数值与术前1 d VAS评分及NDI评分均没有明确的相关性(r=0.238;r=0.250),弧弦距数值与术后1个月和术前1 d VAS评分差值呈正相关且差异有统计学意义(r=0.55,P<0.05),弧弦距数值与术后1个月和术前1 d NDI评分差值呈正相关且差异有统计学意义(r=0.384,P<0.05)。结论应用低温等离子髓核减压术治疗神经根型颈椎病,从疼痛及日常生活功能方面进行观察近期效果良好,疗效较稳定,是一种安全有效的治疗神经根型颈椎病的介入手术方法。

Objective To investigate the clinical efficacy of temperature-controlled plasma radiofrequency ablation in the treatment of nervous root type cervical spondylosis and its correlations with the string-arcing distance.Methods Thirty-four patients with nervous root type cervical spondylosis were enrolled in this study,whose preoperative string-arcing distance was measured.Temperature-controlled plasma radiofrequency ablation was used for treatment.The visual analogue scale(VAS)and neck dysfunction index(NDI)were used to quantitatively evaluate the therapeutic effect.The patients were asked to fill in the forms according to their own health status the day before surgery,1 week after surgery,and 1 month after surgery.Results VAS was(7.21±0.687),(3.12±1.225),and(1.94±1.278)at 1 day before surgery,1 week after surgery,and 1 month after surgery respectively while NDI was(15.79±2.185),(7.85±2.476),and(6.12±3.003)respectively.The VAS and NDI of the patients were lower after treatment,and the difference was statistically significant(P<0.01).There was no clear correlation between the string-arcing distance value and the VAS or NDI(r=0.238;r=0.250).The string-arcing distance was positively correlated with the difference in VAS scores 1 month after surgery and 1 day before surgery,and the correlation was significant(r=0.55,P<0.05).The case was the same with NDI(r=0.384,P<0.05).Conclusions The application of temperature-controlled plasma radiofrequency ablation in the treatment of nervous root type cervical spondylosis has a good and stable effect in terms of pain and daily living functions.It is a safe and effective interventional approach to nervous root type cervical spondylosis.