髓核旋切臭氧牵引联合治疗腰椎间盘突出症

Nucleus pulposus atherectomy decompression and ozone nucleolysis combine lumbar traction in the treatmentof central type lumbar disc herniation

目的观察经皮穿刺髓核旋切减压与腰椎间盘臭氧注射联合术后牵引的综合治疗方案用于中央型腰椎间盘突出症的疗效。方法110例腰椎间盘突出症患者随机分为两组，A组55例Decompressor髓核旋切器，采用经典的后外侧穿刺入路，行经皮髓核旋切腰椎间盘减压术，然后向腰椎间盘内、外注射臭氧；B组55例，在A组的治疗方案基础上，手术后当天开始行连续7d腰椎牵引。予以治疗前和治疗后VAS评分、评价两组疗效并随访观察。结果两组治疗后1d、3d、7dVAS评分与治疗前差异有统计学意义（t=2．159、2．163、2．169、2．167、2．173、2．192，均P〈0．05），术后6个月、12个月随访，B组优良率均优于A组（X^2=74。23、75．11，均P〈0．05）。结论经皮Decompressor髓核旋切减压和臭氧注射联合术后牵引的综合治疗方案用于中央型腰椎间盘突出症疗效确切。

Objective To investigate the clinic technique and effect of treating lumbar disc herniation （LDH） with decompressor and ozone injection combined lumbar traction after surgery. Methods 110 contained LDH patients were randomly divided into two group：decompressor and ozone group, decompressor and ozone combined lumbar traction after surgery group. Under the guidance of CT, fifty-five patients in group A were treated by disc decompression with Decompressor through poster olateral approach, then ozone was injected into the lumbar disc or out side the lumbar disc, and the other fifty-five patients in group B were treated by lumbar traction after surgery that disc decompression and ozone injection same as the group A in once a day and one week of treatment. The theraputic effect was evaluated by comparing VAS,effective rate of therapy before and after treatment. Results The VAS score of two groups at 1,3,7 days between pre-and post-treatment had singificantly different （t = 2. 159,2. 163,2. 169,2. 167, 2. 173,2. 192,all P 〈0.05）. 110 case were followed up after 6 and 12 months,The good-excellent rate of therapy in B group 12 months were better than those of A group （ X^2 = 74.23,75.11, all P 〈 0.05 ）. Conclusion Decompressorcombined ozone injection and lumbar traction after surgery is an effective menthod for treatment of the central type mbar disc herniation.