臭氧髓核消融术联合神经根阻滞治疗腰椎间盘突出症临床应用

Clinical application of ozone marrow nucleus dissolution combined with nerve root blocking anesthesia for treating lumbar intervertebral disc herniation

目的探讨臭氧髓核消融术联合神经根阻滞治疗腰椎间盘突出症的的临床应用。方法选择2007年8月～2010年1月采用臭氧髓核消融术联合神经根阻滞治疗腰椎间盘突出症病人100例。腰椎间盘突出症患者,随机分为2组:A组50例、3d、3、6个月,单纯行臭氧消融术,B组:50例,臭氧消融术联合神经阻滞治疗,治疗前1d、治疗后3、6月测定疼痛视觉模拟评分(VAS),治疗总有效率来评估治疗效果(比较常用的是MaeNab法评价疗效)。结果两组患者治疗后3d、3、6个月VAS值较治疗前ld明显降低(P<0.01或P<0.05),Bd、3、6个月总有效率分别组治疗后3d、3、6个月VAS值较A组明显降低(P<0.05),A组治疗后3为86%、80%、74%,B组治疗后3d、3个月、6个月总有效率分别为98%、88%、84%,B组治疗后3d、3个月、6个月总有效率较A组提高。结论臭氧髓核消融术联合神经根阻滞治疗腰椎间盘突出症临床疗效满意,可成为一种优化的微创手术推广。

Objective To explore the clinical application of ozone marrow nucleus dissolution combined with nerve root blocking anesthesia for treating lumbar intervertebral disc herniation. Methods The 100 patients with lumbar intervertebral disc herniation underwent the operation of ozone marrow nucleus dissolution combined with nerve root blocking anesthesia from Aug 2008- Jan 2010. One hundred patients with lumbar disc herniation were divided into two groups： fifty patients in goup A were treated with ozone marrow nucleus dissolution; fifty patients in group B were treated with ozone marrow nucleus dissolution combined with nerve root block. The therapeutic effect was evaluated by comparing the value of VAS and overall response rate（usually by MaeNab method） at 1 day before treatment and at 3 days, 3 months and 6 months after treatment. Results The value of VAS in two groups at 3 days, 3 months and 6 months after treatment were remarkably lower than that at 1 day before treatment （P〈0.05 or P〈0.01）; The value of VAS in group B at 3 day3, 3 months and 6 months after treatment decreased significantly than those in group A（P〈0.05 or P〈0.01）. The overall response rate of therapy at 3 days, 3 and 6 months were respectively 90.0%, 85.0% and 79.0% in group A, and 100%, 90% and 85.0% in group B. There were no serious side effects in all groups. Conclusion The clinical result of ozone marrow nucleus dissolution combined with nerve root block to treat lumbar intervertebral disc herniation is satisfactory ,this technique could be widely applied as an optimized minimally invasive surgery.