腰椎脊神经后内侧支射频消融术联合内热针治疗Ⅰ~Ⅱ度腰椎滑脱患者的疗效及安全性

Efficacy and safety of radiofrequency ablation in the posterior medial branch of lumbar spinal nerve combined with internal heat acupuncture for the treatment of patients with lumbar spondylolysis at gradeⅠ-Ⅱ

目的评估腰椎脊神经后内侧支射频消融术联合内热针治疗Ⅰ~Ⅱ度腰椎滑脱的疗效及安全性。方法回顾性收集2021年1月1日至2022年4月30日,山东省第二人民医院疼痛科诊治的Ⅰ~Ⅱ度腰椎滑脱患者22例的病例资料。所有患者均接受腰椎脊神经后内侧支射频消融术1次,内热针治疗3次。收集患者一般资料,并记录患者治疗前和治疗后1、6、12、24个月的视觉模拟评分(VAS)、腰椎Oswestry功能障碍指数(ODI),治疗后改良MacNab评分,并发症及不良反应发生情况。结果不同时点VAS、ODI评分差异均有统计学意义(F=92.22,P<0.001;F=205.22,P<0.001)。治疗后1、6、12、24个月患者VAS评分(1.4±0.7,2.3±0.7,2.7±1.0,2.8±1.5)、ODI指数(15.4±8.4,20.8±6.8,22.1±6.6,22.4±6.9)均较治疗前降低(P均<0.05);治疗后24个月优良率明显低于治疗后1、6、12个月[31.8%(7/22例)比100.0%(22/22例)、100.0%(22/22例)和72.7%(16/22例),P均<0.05]。所有患者均未见严重并发症及不良反应。结论腰椎脊神经后内侧支射频消融术联合内热针治疗可明显减轻Ⅰ~Ⅱ度腰椎滑脱患者腰部疼痛,改善腰椎日常功能,短期临床疗效较好。

Objective To evaluate the efficacy and safety of radiofrequency ablation in the posterior medial branch of lumbar spinal nerve combined with internal heat acupuncture for the treatment of patients with lumbar spondylolysis gradeⅠorⅡ.Methods From January 1,2021 to April 30,2022,22 patients with gradeⅠorⅡlumbar spondylolysis,in the Department of Painology,Shandong Second Provincial General Hospital,were retrospectively analyzed.All patients underwent radiofrequency ablation in the posterior medial branch of lumbar spinal(1 time),and internal heat acupuncture(3 times).General data of patients,visual analogue scale(VAS),Oswestry disability index(ODI),modified MacNab score and incidence of complications and adverse reactions were recorded.Results The differences were statistically significant in VAS and ODI at different time points respectively(F=92.22,P<0.001;F=205.22,P<0.001).VAS(1.4±0.7,2.3±0.7,2.7±1.0,2.8±1.5)and ODI(15.4±8.4,20.8±6.8,22.1±6.6,22.4±6.9)were lower at 1,6,12 and 24 months after the treatment than those before the treatment(all P<0.05).The excellent and good rate was significantly lower at 24 months after the treatment than that at 1,6 and 12 months after the treatment[31.8%(7/22 cases)vs.100.0%(22/22 cases),100.0%(22/22 cases)and 72.7%(16/22 cases),all P<0.05].No serious complications or adverse reactions were found in all patients.Conclusion Radiofrequency ablation in the posterior medial branch of lumbar spinal nerve combined with internal heat acupuncture can significantly reduce the pain of patients withⅠ-Ⅱgrade lumbar spondylolysis,improve daily function,and has a good short-term clinical efficacy.