三氧靶点注射微创消融术治疗腰椎间盘突出症

Clinical study of minimally invasive ablation by O_3 targeted in jection in lumbar in tervertebral disc protrusion

目的:对比观察三原子氧靶点注射和硬膜外腔注射激素复合液治疗腰椎间盘突出症的疗效。方法:选择300例腰椎间盘突出症患者随机分成2组,每组150例,在C臂X线引导下,实验组患者经小关节内侧缘行椎间盘穿刺,经椎间盘造影确认穿刺针位于椎间盘突出物的中心(靶点),注入40 ug/ml三原子氧10 ml,行靶点消融。对照组患者经小关节内侧缘行硬膜外侧隐窝穿刺,经硬膜外前间隙造影确认穿刺针位于突出椎间盘外,注入激素复合液(20 g/L利多卡因5 ml,曲安缩松40 mg,神经妥乐平7.2 u,维生素B122 mg)。观察近远期疗效,抽样复查治疗前后的CT变化情况。结果:实验组对照组2周优良率分别为60.1%、59.3%(P>0.05),3个月优良率分别为86.0%、40.6%(P<0.01),6个月优良率分别为97.3%、32.6%(P<0.01)。6个月后2组随机抽出30例进行CT复查,实验组突出物消失11例,突出物缩小(≥2 mm)15例,变化不明显4例,对照组CT变化均不明显,仅密度降低。结论:三原子氧靶点注射微创消融术治疗腰椎间盘突出症疗效明显高于硬膜外注射激素复合液组,CT复查突出物消失或明显缩小,微创、安全有效。

Objective： To compare the therapeutic effects of O3-targeted-injection ablation and epidurally hormone-mixed liquor injection in lumbar intervertebral disc protrusion.Methods： 300 patients with lumbar intervertebral disc protrusion were randomly divided into two groups（n=150 each）.Guided by X-ray of C-arm,experimental group were punctured through the medial border of small joint.After confirming the needle in the center of protrusion（target）,40ug/ml O3 10ml was injected for targeted ablation.The control group was punctured through epidural lateral recess.After confirming the needle outside of the diseased disc by epidural anterior diastema opacification,hormone mixed liquor including 2% lidocaine 5ml,Triamcinolone Acetonide 40mg,Neurotropin 7.2u and vitamin B12 2mg were injected.The close and prostecdtive efficacy were observed.Recheck the change with CT after and before therapy by sampling.Results： Superordinary percentage of experimental group and control group were 60.1% and 59.3%（P〉0.05）in two weeks,86.0% and 40.6%（P〈0.01）in three month,97.3% and 32.6%（P〈0.01）in 6 month respectively.6 months later,30 samples of each group were selected to accept CT examination.The protrusion disappeared in 11 cases,contracted in 15 cases,and didn＇t change obviously in 4 cases in experimental group.All cases didn＇t change obviously in control group.Conclusion： Therapeutic effect of minimal invasive ablation by O3 injection is better than hormone-mixed liquor injection in lumbar intervertebral disc protrusion.