CT导向下臭氧介入治疗腰椎间盘突出症32例

Ozone intervention for 32 cases of lumbar intervertebral disc herination under computed tomography monitoring

目的:观察CT导向下臭氧注入治疗腰椎间盘突出症的临床效果。方法:选择2005-01/2006-10在平顶山煤业集团一矿医院外科就诊的腰椎间盘突出症患者32例,术前均经保守治疗,效果不满意而同意接受臭氧注射治疗。在CT引导下向突出椎间盘内注入臭氧,突出物为旁中央型者,经神经根与硬脊膜囊之间穿刺进入椎间盘内;突出物为外侧型者,经神经根外侧,小关节突内缘穿刺进入椎间盘内。分别于盘内及实物中央注射,剂量为60mg/L,臭氧5～15mL,总量小于30mL。臭氧注射治疗后3个月通过随访及复查CT判定治疗效果,疗效评定标准:①显效:症状完全消失,恢复正常工作和生活。②有效:偶有疼痛不适,不影响日常工作生活。结果:32例患者全部进入结果分析,无脱落。①注射臭氧后CT监视可见臭氧在盘内分布呈裂隙状、树枝状,髓核腔内积聚状及大部分溢出盘外状。②32例患者均随访3个月,无失访病例,显效率为81.2%(26/32),有效率为12.5%(4/32)。结论:CT导向下臭氧介入治疗腰椎间盘突出症定位准确、疗效确切,安全性高,为治疗椎间盘突出症较为理想的方法。

AIM： To Investigate the clinical effect computed tomogrephy （CT） monitoring on herniation. METHODS： Thirty-two patients with lu of ozone infusion under lumbar intervertebral disc mbar intervertebral disc herniation, who were not satisfied with the conservative therapy, received the ozone interventional therapy. Under CT monitoring, the ozone was injected into the patients of parecentral herination between nerve root and dural sac, and into the patients of lateral herination through the nerve root and small articular process to the intervertebral disk at a dose of 60 mg/L （5-15 mL ozone） and volume dose in 30 mL. Three months later, the curative effect was evaluated on the basis of follow up and imageology： favorite effect, if the symptoms disappeared completely, and the work and life restored; effective, if having pain some times, but no influence to daily work and life. RESULTS： Thirty-two cases were involved in the result analysis without any loss. CT scanning showed after infusion, ozone was slit-shaped, arborization, and accumulated in nucleus gelatinosus and flowing outward lumbar disc. Thirty-two patients were followed up for 3 months, and the favorite effect and effective rates were 81. 2% （26/32） and 12.5% （4/32）, respectively. CONCLUSION： Ozone infusion monitored under CT is an effective approach to treat lumbar intervertebral disc herination with accurate orientation, good curative effect, and high security.