CT引导下臭氧联合经皮射频热凝注射治疗颈椎间盘突出症

THE CLINICAL EFFICACY OF INTRADISCAL OZONE INJECTION COMBINED WITH RADIOFREQUENCY THERMOCOAGULATION TECHNOLOGY IN THE TREATMENT OF CERVICAL DISC HERNIATION

目的:观察经皮穿刺盘内臭氧髓核化学溶解联合射频热凝治疗颈椎间盘突出症的临床效果。方法:颈椎间盘突出症患者528例,分为臭氧组264例,臭氧+射频组264例。均在CT引导下经颈前血管鞘和气管鞘之间穿刺入椎间盘髓核或突出物靶点。臭氧组每个盘内注射浓度为50μg/ml的臭氧4 ml。臭氧+射频组盘内注射浓度为50μg/ml的臭氧后再行髓核或/和突出物射频热凝,设定最高温度为90℃,时间为4个周期。观察治疗后各个时期的疼痛视觉模拟评分(visual analoguescale,VAS)以及临床效果。记录治疗过程中及治疗后的并发症。结果:治疗后不同时期(24小时、1周、1个月、3个月及6个月)疼痛VAS评分与术前相比显著改善。且臭氧+射频组在治疗后3个月及6个月的VAS评分较臭氧组明显降低。治疗后6个月,臭氧组优良率为80.3%,臭氧+射频组优良率为86.5%。无一例发生严重并发症。结论:CT引导下经皮穿刺臭氧髓核化学溶解联合射频热凝是治疗颈椎间盘突出症有效的方法之一。

Objective： To observe the clinical efficacy of intradiscal ozone （03） injection combined with radiofrequency （RF） thermocoagulation for the treatment of cervical disc herniation. Methods： 528 patients with cervical disc herniation were randomly and evenly divided into two groups： 03 group （264 cases） and O3＋RF group （264 cases）. Under CT guiding, the needles were inserted into the nucleus pulposus and/or targets of cervical intervetebral disc through the path between anterior jugular tracheal sheath and vagina vasornm. In the 03 group, each disc was injected with ozone 50 gg/ml （4 ml）. In the O3＋RF group, after injection of ozone 50 ~tg/ml （4 ml）, RF thermocoagulation was performed within nucleus pulposus and/or targets with the highest temperature of 90~C for 4 cycles. The VAS scores and complications were recorded at 24 h, 1 w, 1 month, 3 months and 6 months after treatment. Results： Compared with before treatment, VAS scores were decreased significantly from 24 h to 6 months after treatment. Corapared with 03 group, VAS scores were remarkably reduced in the O3＋RF group at 3 months and 6 months after treatment. The excellent and good rate was 80.3% in 03 group and 86.5% in O3＋RF group at 6 months after treatment. There was no any serious complication in this study. Conclusion： CT guided intradiscal ozone injection combined with RF thermocoagulation is an effective procedure for treatment of cervical disc herniation.