腰椎间盘MRIT_2高信号区在射频治疗椎间盘源性下背痛中的应用

Application of Lumbar Disc High Signal Area on MRIT_2 for Treating the Lumbar Intervertebral Source Low Back Pain with the Radio Frequency

目的:探讨腰椎间盘MRI高信号区与椎间盘源性下背痛的相关性。方法:下背痛患者47例,根据腰椎间盘MRIT2信号强弱进行腰椎间盘退变程度评估分级,对具有MRIT2高信号区的椎间盘进行造影及射频热凝治疗,并分别于治疗前24 h内,治疗后7、15及90 d时采用VAS疼痛评分法进行疗效评定。结果:具有MRIT2高信号区的椎间盘造影显示所有纤维环均为2-3级破裂,且高信号区均出现在退变椎间盘内,高信号区与纤维环破裂程度及椎间盘退变程度呈正相关(r=0.7859、0.8135,P=0.025、0.01);射频治疗后VAS评分较治疗前有显著降低(P<0.05),治疗后90 d随访时疗效评定优良率85%,有效率95.7%,与治疗前比较有显著改善(P<0.01)。结论:具有MRI高信号区的椎间盘是引起椎间盘源性下背痛的责任椎间盘,对其进行射频治疗,可取得良好效果。

Objective： To explore the relationship between lumbar disc high signal area in MRI and lumbar intervertebral low back pain. Methods： According to the signal intensity of lumbar intervertebral MRIT2, the degrees of lumbar disc degeneration were assessed and graded in 47 cases of low back pain. The lumbar disc with high signal area on MRIT2 received contrast examination and radio frequency treatment. Twenty-four h before and 7, 15 and 90 days after treatment, the effectiveness was assessed by using VAS ache grade. Results： Contrast examination of lumbar disc with high signal area on MRIT2 revealed that all fiber rings were broken with grade Ⅱ-Ⅲ. The high signal area existed in the degenerated lumbar disc. High signal area was positively correlated with the severity of fiber rings rupture and lumbar disc degeneration （r = 0. 7859, 0. 8135, P= 0. 025, 0.01）. After radio frequency, scores of VAS was significantly reduced as compared with those before treatment （P〈0.05）. Ninety days after treatment, curative effectiveness assessment revealed that the excellent rate and effective rate was 85% and 95.7% respectively （P〈0.01）. Conclusion： The lumbar disc having the high signal area on MRI is a duty disc to cause the low back pain. Radio frequency could obtain good results.