CT引导下盘内外臭氧治疗椎间盘源性腰痛50例临床分析

Clinical analysis of 50 cases of CT-guided disc ozone injection treatment on discogenic low back pain

目的探讨CT引导下臭氧治疗椎间盘源性腰痛的疗效。方法选取符合椎间盘源性腰痛标准50例患者,在CT引导下对58个椎间盘进行穿刺,在盘内及椎间孔区分别注射浓度为50μg/mL及35μg/mL的臭氧,根据视觉模拟评分及改良的Macnab疗效评定标准进行评定,观察疗效。结果 CT引导下均一次穿刺成功,58个间盘注射臭氧后均诱发或复制出下腰部疼痛,CT表现为纤维环部分撕裂18例,完全撕裂40例,术前及术后3d、3个月、6个月的视觉模拟评分分别为7.53±1.51、4.10±0.43、1.96±0.43、1.71±0.53,术前与术后各个时间段对比,差异具有统计学意义(P<0.05);术后3d、3个月、6个月的优良率分别为79.8%、89.7%、91.2%。结论 CT引导下盘内外注射臭氧治疗椎间盘源性腰痛操作简单,安全准确,不仅具有影像学诊断价值,而且疗效良好。

Objective To probe into the curative effect of CT-guided ozone treatment on discogenic low back pain. Methods 50 sufferers with discogenic low back pain were selected and CT-guided punctured at 58 intervertebral discs.Ozone with concentration of 50 i^g/mL and 35 p.g/mL was respectively injected into the disc and the intervertebral foramen.Visual analogue scale and modified Macnab were adopted to evaluate the curative effect.Results CT-guided puncture success was achieved at one time, 58 intervertebral discs were all induced and copied low back pain after ozone injection.CT showed 18 cases had fibrous ring partial tear,40 had com- plete tear.Visual analogue scales before operation and 3 days, 3 months and 6 months after operation were respectively 7.53 ~ 1.51, 4.10~ 0.43,1.96~ 0.43,1.71 ~ 0.53.The differences of different stages before and after the operation were of statistical significance （P〈0.05）.The excellent rates of 3 days, 3 months and 6 months after operation were respectively 79.8%, 89.7%,and 91.2%.Conclu- sion CT-guided disc ozone injection treatment on discogenic tow back pain is easy to operate, safe and accurate, which has not only imaging diagnosis value but also good curative effect.