臭氧治疗术在复杂性腰椎间盘突出症治疗中的临床观察

Ozone therapy for the complex prolapse of lumbar intervertebral disc:a clinical observation

目的探讨臭氧(O2-O3混合气体)治疗术在复杂性腰椎间盘突出症治疗中的效果。方法选择单纯腰椎间盘突出症患者70例,选择椎间盘内负压11例,腰椎间盘髓核摘除术后复发5例,伴椎管狭窄10例,伴腰椎退行性变、腰椎骨质增生、小关节退行性变30例,伴侧隐窝变窄4例,伴腰肌劳损10例,行CT引导下经皮穿刺臭氧治疗术,盘内注入臭氧量2～3ml,椎旁间隙注入臭氧量5～8ml,O3浓度为(30～40μg/ml)。合并腰肌劳损者,根据病理解剖特征,采用20ml一次性注射器抽取臭氧,对疼痛组织内行浸润注射,隔日1次,3次为一疗程。结果通过对70例腰椎间盘突出症患者及70例复杂性腰椎间盘突出症患者治疗后的对比,显示80%患者术后症状立即缓解,术后1周有效率达95%,随访3、6个月有效率可达96%。结论正确的临床诊断,准确的手术操作,以及合理的将臭氧联合应用于软组织损伤性疼痛中,可明显提高复杂性腰椎间盘突出症患者的治疗效果。

Objective To evaluate the therapeutic outcome of ozone injection therapy for the treatment of complex prolapse of lumbar intervertebral disc, which is accompanied with spinal stenosis due to hypertrophy of ligamentum flavum, degeneration of intervertebral facet joints, intervertebral hyperosteogeny and degeneration, lumbar muscle strain and negative pressure in intervertebral discs. Methods Seventy patients with simple intervertebral disc prolapse （simple group） and 70 patients with complex interverlebral disc prolapse （complex group） were selected for the study. The complex intervertebral disc prolapse included negative pressure in intervertebral disc （n = 11）, recurrence after resection of nucleus polposus of intervertebral disc （n = 5）, spinal stenosis （n = 10）, degeneration of intervertebral facet joints and inlerver- tebral hyperosteogeny （n = 30）, stenosis of lateral recess （n = 4） and lumbar muscle strain （n = 10）. All patients were treated with ozone injection under the CT guidance. A total of 2-3 ml ozone with the concentration of 40 - 50 μg/ml was injected into the intelwertebral disk and a total of 5-8 ml ozone with the concentration of 30 - 40 μg/ml was injected into the paraspinal space. Infiltration injection into the pain spots with 20 ml ozone was carried out in patients with lumhar muscle strain. Results A comparison of the therapeutic outcomes between simple group and complex group was made. Immediate relief from clinical symptoms was obtained in 80% of all treated patients. The effective rate one week after the procedure was 95%, which became 96% at 3 - 6 months after the treatment. Conclusion Correct clinical diagnosis, skilled and accurate manipulation during the surgery and reasonable use of ozone injection in the treatment of soft tissue injury, etc. can markedly improve the therapeutic effect for complex lumbar intervertebral disc prolase.