盘内注射胶原酶治疗颈椎间盘突出症的临床观察

Effects of intradisc collagenase on herniated cervical disc

目的对颈椎间盘盘内注射胶原酶治疗颈椎间盘突出症的疗效进行评估。方法对37例颈椎间盘突出症患者,将国产胶原酶冻干制品300 U溶于生理盐水0．3 ml中,于局部麻醉和影像增强监视下注入突出的椎间盘盘内。所有患者在注射前后均作影像学评价。结果术后6～12个月的随访观察表明,37例患者中32例(占86．5％)疼痛明显减轻或消失,临床效果满意;3例(8．1％)效果可;2例(5．6％)效果不满意。6个月CT复查结果显示,突出物较术前缩小80％以上的有9例,缩小50％-79％的有21例,缩小20％-49％的有5例,未超20%的有2例,优良率达81％。结论对于颈椎间盘突出症,胶原酶颈椎间盘化学松解术是一种有效的治疗方法。

Objective To evaluate the effects of intradisc collagenase on herniated cervical disc. Methods Thirty-seven patients suffered from herniated cervical disc received chemonucleolysis with intradisc collagenase 300 U under X-ray guidance and local anesthesia. Preoperative and postoperative imageological assessments were made. Results Follow-up of 6 to 12 months revealed that, in 32 of 37 cases （86.5%） ,the pain alleviated remarkably or even disappeared,while in 3 cases （8. 1% ）showed moderate pain alleviation ,and 2 cases（5.6% ） had little improvement. Computed tomography scan in these respond to chemonucleolysis showed that herniated nucleus pulposus retreated more than 80% in 9 cases,50%-79% in 21 cases,20%--49% in 5 cases,and less than 20% in 2 cases. Conclusion With respect to herniated cervical disc,chemonucleolysis with intradisc collagenase is an effective method.