不同微创介入法治疗腰椎间盘突出症的比较研究

Comparison of Minimally Invasive Interventional Treatment of Lumber Disc Herniation

目的观察3种微创介入疗法治疗腰椎间盘突出症的临床疗效,筛选出更好的治疗手段。资料与方法将高唐县人民医院2008-01-01～2010-06-31接诊的、资料完整的300例腰椎间盘突出症患者随机分成3组。分别用单纯应用后路(小关节内侧路径)、侧后路及后路加侧路联合微创介入治疗腰椎间盘突出症。各组治疗前后腰腿疼痛情况用VAS(visualanaloguescale)评估。参照日本骨科学会(JOA)1984年制定的腰腿痛疗效标准(29分法)评价各组临床治疗效果。治疗前严格对每个患者体检,同时认真分析CT或MRI影像表现采用个体化剂量治疗。结果治疗前各组间VAS评分比较差异无统计学意义;治疗后VAS评分后路加侧路联合明显低于其他两组,单纯应用后路、侧路组VAS评分差异无统计学意义;近中期JOA评分优良率联合组后路加侧路与其他两组比较差异有统计学意义,单纯应用后路、侧路组间比较差异无统计学意义。结论后路加侧路联合注射组临床疗效明显优于其他两组,单纯应用后路或侧路无明显差异。

Purpose To compare the clinical effect of three minimally invasive interventinal treatments of lumber disc herniation（LDP）.Materials and Methods A total of 300 patients were randomly divided into 3 groups and treated with intervertebral injection of ozone viaback route,side route,both back and side routes respectively.Before and after treatment,VAS（Visual analogue scale）was used to evaluate the back and leg pain of LDP patients.Patients received physical examinationbefore the treatment,and CT or MRI images were analyzed to determine individual dosage.Results Pre-treatment VAS scores were not significantly different among 3 groups.After treatment,the VAS score was significantly lower in the group with combination back and side route injection,but similar in the 2 groups with either back route or side route treatment.Conclusions In treatment of LDP,The clinical effect of combination back and side route group was superior than that in back route group and side route group.