胶原酶盘外注射治疗腰椎间盘突出症附24O例疗效分析

Extradiscal Injection of Collagenase in The Treatment of Herniated Lumbar Disc-A Therapeutic Analysis of 240 Cases

采用胶原酶盘外注射治疗腰椎间盘突出症263例。全部病例具有典型的临床症状和体征，经CT或MRI确诊并且保守治疗无效。对其中24O例进行了3月、6月及12月的随访，治愈率为62％，总有效率为92％，无效率为8％。阐述了胶原酶盘外注射的理论依据，胶原酶能够溶解椎间盘突出物，而对椎管内其他组织无明显毒副作用。分析了注射后疼痛反应的机制。认为胶原酶溶解术的疗效与适应证的选择、注射部位的准确性及药物剂量密切相关。胶原酶盘外溶解术是一种安全、简便和有效的治疗腰椎间盘突出症的方法。

263 cases of lumbar disc herniation were treatedwith extradiscal injection of collagenase. All patientswith typical clinical symptoms and signs werediagnosed by CT scanning or MRI, and all of themwithout therapeutic effect with conservative therapy.Among them, 240 cases had been followed up clinicallyfor 3-12 months.The results showed that the curerate, effective rate and ineffective rate were 62%, 92%and 8% , respectively. The theoretical foundation ofextradiscal injection of collagenase was expounded thatcollagenase could dissolve the herniation of lumbar discbut did not affect to adjacent structures. Themechanisms of pain response after discolysis wereanalysed. The writers thought that the therapeutic effectof discolysis is closely related to the choice of theindication, the accuracy of the injection site, and thedosage of collagenase. Extradiscal discolysis is a safe,convenient and efficient method for treating herniatedlumbar disc.