腰椎间盘内破裂的诊断与微创介入治疗

Diagnosis and minimally invasive treatment of internal disc disruption

目的探讨腰椎间盘内破裂的诊断和微创介入治疗方法。方法对38例顽固性腰腿痛患者,经腰椎间盘造影证实为腰椎间盘内破裂,对造影阳性椎间盘行射频热凝联合臭氧介入治疗,采用改良MacNab腰腿痛手术评价标准联合11点数字评分法(NRS-11)评定疗效。结果术后随访6～21个月,平均16个月,显效23例,有效13例,无效2例,治疗前、后11点数字评分,差异有统计学意义(P<0.01)。结论腰椎间盘造影能定性诊断椎间盘内破裂,射频热凝联合臭氧介入治疗是椎间盘内破裂的有效治疗方法 。

Objective To study the diagnosis and minimally invasive treatment of internal disc disruption.Methods Thirty eight patients with refractory lumbago showed internal disc disruption by discography.Radiofrequency thermocoagulation combined with ozone interventional therapy was performed on the positive intervertebral disk;The therapeutic effect was determined by the modified MacNab criterion of lumbocrural pain operation and the 11-point numeric rating scale （NRS11）.Results All cases were followed-up for 6-25 months,averaging 16 months.Among the 32 cases,the therapeutic method was obviously effective in 20 cases,effective in 11 cases,ineffective in one case.There was a significant difference in the NRS-11 between pre and post treatment （P 0.01）.Conclusion Internal disc disruption can be diagnosed by lum bar diskography.The radiofrequency thermocoagulation combined with ozone interventional therapy is an effective treatment.