盘内注射胶原酶治疗上段腰椎间盘突出症

Collagenase injected in disk to treat lumbar intervertebral disk herniation

目的:探讨盘内注射胶原酶的方法治疗上段腰椎间盘突出症的可行性、疗效及安全性。方法:28例单纯上段腰椎间盘突出症患者,男16例,女12例;年龄21～62岁,平均44.5岁。病程3个月～10年。椎间盘突出4～9mm,平均4.9mm。采用椎旁进针盘内注射或突出物内注射胶原酶的方法进行治疗,随访观察有效率、突出椎间盘溶解、椎间隙感染等并发症发生情况。结果:所有患者随访1～6个月,依据Macnab评价标准进行疗效评价,优9例,良12例,可4例,无效3例。突出椎间盘溶解0～6mm,平均3.5mm。17例进行了重复注射,其中9例患者进行了3次注射。13例注射后短期内症状加重,对症处理后缓解。结论:盘内注射胶原酶的方法治疗上段腰椎间盘突出症效果理想、安全可行。

Objective：To probe the therapeutic effect in the treatment of up intervertebral disc herniation by injected collagenase in disk. Methods：There were 28 patients involving 16 males and 12 females with an average age of 44. 5 years ranging from 21 to 62. The course was 3 months to 10 years. The average disc herniation was 4. 9 mm ranging from 4 to 9 mm. The lumbar disc herniation were treated by collagenase injected in disk. The outcome, solution of herniated disc, complications such as infection in disc were followed and observed. Results： All patients were followed-up for 1 to 6 months. According to evaluated standard of Macnab, the result was excellent in 9 cases, good in 12, improved in 4, and ineffective in 3. The solution of herniated disk was 0 - 6 mm, the average was 3. 5 ram. Seventeen patients were injected twice, of which 9 patients were injected three times. There were 13 cases with symptom progression after injection herniation is short period, but the situation was relieved after therapy in time. Conclusion：The effect of injection of collagenase in disk to treat lumber intervertebral disk herniation is an effective and safe method.