射频消融纤维环成形术在治疗椎间盘源性腰痛中的作用

Efficacy of radiofrequency ablation and annuloplasty in the treatment of discogenic low back pain

[目的]探讨射频消融、纤维环成形在经皮椎间盘部分切除术治疗椎间盘源性腰痛中的作用。[方法]将本院2010年2月～2011年2月收治的60例椎间盘源性腰痛患者随机分为A组(30例)采用Disc-FX通道系统辅助下经皮椎间盘部分切除术加射频消融、纤维环成形术治疗和B组(30例)采用该系统辅助下的经皮椎间盘部分切除术治疗。男32例,女28例;年龄35～59岁,平均47.9岁。分析两组患者年龄、病程、手术前后腰痛VAS评分及ODI评分、手术时间。[结果]术后随访9～21个月,平均15.9个月。两组在年龄、病程、术前腰痛VAS评分及ODI评分、手术时间差异均无统计学意义;两组术后1、6个月及末次随访时腰痛VAS评分及ODI评分与术前相比降低,差异有统计学意义;与B组相比A组术后腰痛VAS评分及ODI评分降低更明显,差异有统计学意义。[结论]射频消融、纤维环成形在经皮椎间盘部分切除术治疗椎间盘源性腰痛中具有一定作用。

[ Objective ] To investigate the efficacy of radiofrequency ablation and annuloplasty during percutaneous partial discectomy for discogenic low back pain. [ Methods] From Febrary 2010 to Febrary 2011,60 discogeic pain patients were trea- ted with Disc - FX system. The 60 patients were randomized to either group A （30 cases） being treated with percutaneous partial discectomy and radiofrequency ablation and annuloplasty or group B （30 cases） being treated with percutaneous partial discecto- my only. There were 32 males and 28 females, with an average age of 47. 9 years （ ranged, 35 ~ 59 years） . The age, course of disease, surgical time, low back pain visual analogue scale （VAS） and Oswestry disability index （ODI） were analyzed pre - and postoperatively. [ Results] All the 60 patients were followed up for 9 to 21 months, with an average of 15. 9 months. The age, course of disease, surgical time, preoperative low back pain VAS and ODI had no significantly differences between the groups, and the VAS and ODI decreased significantly after the operation. The postoperative VAS and ODI in group A decreased more significantly than those in group B, the difference between the groups had a statistical significance. There was no surgery complication during the follow up period. [ ConclusionI Radiofrequency ablation and annuloplasty in the treatment of discogenic low back pain with the percutaneous partial discectomy has a certain efficacy.