CT引导介入治疗腰椎间盘突出症

CT-guided Percutaneous Interventional Treatment for the Lumbar Disc Hernia

目的探讨CT引导射频结合胶原酶介入治疗腰椎间盘突出症的临床应用价值。方法对48例临床诊断为腰椎间盘突出症、经CT检查证实的患者进行CT导引下射频联合胶原酶介入治疗,全部病例进行突出物内射频热凝和突出物内注射0.45 ml 275 U胶原酶,其中L4/5椎间盘病变23例,L5/S1椎间盘病变25例。结果穿刺成功率100%,6个月后随访,腰椎间盘突出症状缓解情况:优25例、良20例、可3例、差0例。CT复查突出物明显变小26例,部分变小22例。本研究过程未出现过敏反应、神经根损伤等并发症。结论 CT引导介入治疗是腰椎间盘突出症的有效治疗方法。

Objective To investigate the clinical value of CT-guided percutaneous radiofrequency combined with collagenase treatment for lumbar disc hernia.Methods A total of 48 patients with lumbar disc hernia diagnosed by clinic and CT accepted CT-guided percutaneous radiofrequency combined with collagenase （0.45 ml 275 U） treatment. There were 23 cases of L4/5 lesions and 25 cases of L5/S1 lesions.Results Injection was done successfully in all patients. After 6 months, 48 patients were contacted for clinical follow-up and repeat CT examination were performed to verify the status of the herniated lumbar disc material. The clinical rate of excellence and good results were 93.7%. The protrusion reduced as by CT scan in 48 cases （100%）. No allergic phenomena or neurologically adverse reactions were observed.Conclusion CT-guided percutaneous radiofrequency combined with collagenase is effective in treating lumbar disc hernia.