腰痛治疗的程序与筛选

Procedure and screening of treatment for low back pain

自１９８６年至１９９２年，将椎间隙阻滞加＂十＂字型阻滞应用于不伴下肢痛的腰痛病人１０１例。椎间隙阻滞穿刺点选择在腰１～骶１之间疼痛严重的椎间隙。将药液（１０ｇ／Ｌ利多卡因４ｍｌ加泼尼松６２．５ｍｇ的合液，共６ｍｌ）分别注入于黄韧带、棘间韧带、皮下组织里，但不需注入于硬膜外腔；其次，选择腰３～４或腰４～５间皮肤上进行“十”字型阻滞，穿刺针经皮下以十字型注入５ｇ／Ｌ利多卡因１０～１２ｍｌ．其结果如下。著效（疼痛计分０～１）：７２例（７１％）；良效（疼痛计分２～８）：２５例（２５％）；无著效（疼痛计分９～１０）：４例（４％）．认为，在腰痛治疗上，门诊７个程序和住院８个程序可供选择，而首选的治疗方法是椎间隙阻滞和“十”字型阻滞的方法，这种方法的优点：①几乎没有合并症；②安全；③操作技术简便易行；④适合于处理大量的病人，尤在门诊；⑤易被就诊病人接受；③可获满意的疗效。

One hundred and one patients with low back pain( LBP) and without leg pain were treated with intravertebral block added with'十'type block(IVB'十'TB) during 1986-1992, The IVB puncture points were selected from serious pain area of L1-S1. The Medicinal solution (10g/L xylocain 4ml+ prednisolone 62.5mg, total 6ml) was injected into ligamentum flavum, interspinous ligament, supraspinous ligament, subcutaneous tissue, but did not need to be punctured into epidural space.'十'TB was performed at the skin point of L3-L4 or L4-L5, the 5g/L xylocain 10-12 ml was injected subcutaneously by'+'TB, The results were as follows: Excellent(pain score 0-1) 72 cases,good(2-8) 25cases, fair (9-10) 4 cases. Among 7 procedures in pain clinic and 8 procedures in inpatients for LBP, the first choice of treatment for LBP was IVB + TB.