C型臂引导下Disc—FX双极射频系统行髓核摘除术、射频消融术和纤维环成形术治疗椎间盘源性腰痛的效果

Efficacy of lumbar discectomy, radiofrequency ablation and annuloplusty performed with Disc-FX system under guidance of C-arm in treatment of discogenic low back pain

目的评价C型臂引导下Disc—FX双极射频系统行髓核摘除术、射频消融术和纤维环成形术治疗椎间盘源性腰痛的效果。方法椎间盘源性腰痛患者28例，视觉模拟评分（VAS评分）〉7分，性别不限，年龄27～73岁，在C型臂引导下采用Disc—FX双极射频系统行髓核摘除术、射频消融术和纤维环成形术。随访至术后2个月，采用VAS评分评价疼痛程度，分别于术前、术后7、14d、1个月、2个月记录VAS评分，根据VAS评分评价术后2个月镇痛有效情况，术后2个月根据Macnab标准评价疗效。记录手术相关不良反应的发生情况。结果与术前比较，术后不同时点VAS评分降低（P〈O．05），术后2个月时镇痛有效率为93％；按Macnab标准评价疗效：优17例，良9例，可2例，优良率93％。1例女性患者发生腰椎静脉丛损伤，无一例患者发生椎间盘感染、神经根损伤和脊髓损伤。结论C型臂引导下Disc—FX双极射频系统行髓核摘除术、射频消融术和纤维环成形术治疗椎间盘源性腰痛的优良率为93％，不良反应较少。

Objective To evaluate the efficacy of lumbar discectomy, radiofrequency ablation and annulo- plusty performed with Disc-FX system under the guidance of C-arm in treatment of discogenic low back pain. neth- otis Twenty-eight patients with discogenic low back pain, with VAS score greater than 7, aged 27-73 yr, under- went lumbar discectomy, radiofrequency ablation and annuloplusty performed using Disc-FX system under the guid- ance of C-arm. The patients were followed up for 2 months after surgery and pain was assessed using VAS score. VAS scores were recorded before surgery, and at 7 and 14 days and 1 and ：2 months after surgery. The effective analgesia was recorded according to VAS scores. The therapeutic effect was evaluated according to Macnab stan- dard 2 months after surgery. Results VAS scores were significantly lower at each time point after surgery than be- fore surgery （ P 〈 0.05）. The rate of effective analgesia was 93 % at 2 months after surgery. The excellent and good rate of the therapeutic effect evaluated was 93 % . One female patient developed injury to lumbar venous plex- us, and no patients developed infection of intervertebral disk, nerve root injury or spinal cord injury. Conclusion The excellent and good rate is 93 % when lumbar discectomy, radiofrequency ablation and annuloplusty performed using Disc-FX system is used for treatment of discogenic low back pain under the guidance of C-arm, with fewer side effects.