双平板DSA引导下经皮穿刺臭氧消融术治疗腰椎间盘突出症的临床疗效观察（附37例报告）

Effect and Therapeutic Outcome of Biplane DSA and its C-arm Cone-beam CT Imaging in the Treatment of Ozone Injection Therapy for Lumbar Disc Herniation

目的：观察双平板DSA及其类CT功能在经皮穿刺臭氧消融术治疗腰椎间盘突出症中的应用及临床疗效。方法回顾性分析37例腰腿疼痛或麻木患者，平均年龄（49.38±13.05）岁，共44个病变椎间盘，经CT或MRI证实为腰椎间盘突出症，在双平板DSA设备透视引导下行经皮穿刺臭氧消融术，术中每个椎间盘内注射臭氧4～25 mL（平均13.82±3.62 mL），盘外神经根周围注射臭氧0～15 mL（平均7.73±2.87 mL），并于盘内外注射曲安奈德水针共5 mL。观察术前及术后1周、1个月、3个月、6个月、1年腰腿疼痛变化情况，同时观察术中术后并发症发生情况。结果37例患者中，34例于臭氧消融术后腰腿疼痛VAS评分明显下降，并且疼痛缓解时间大于1年，改良Macnab疗效评定总有效率91.89%；3例疼痛缓解不明显，其中1例出现椎间盘感染。结论双平板DSA引导下经皮穿刺臭氧消融术治疗腰椎间盘突出症，创伤小，并发症少，止痛效果确切。

Objective To observe the effect of biplane DSA and its C-arm cone-beam CT imaging in the treatment of ozone injection therapy for the lumbar disc herniation and to evaluate its therapeutic outcome. Meth-ods Retrospective analysis of 37 cases with lumbocrural pain or numbness patients, the mean age is （49.38±13.05） years, forty-four intervertebral discs were treated, CT or MRI conifrmed lumbar disc herniation. We perfomed ozone injection therapy under biplane DSA machine, during the procedure, 4 to 25 mL （mean 13.82±3.62 mL） ozone was injected in each lesion disc, and 0～15 mL was injected around the nerve root, then a total of 5mL tri-amcinolone acetonide was also injected in the disc and paraspinal. Then we observe the changes of lumbocrural pain pre-procedure, and 1 week, 1 month, 3 months, 6 months, 1 year after it. Besides, the intraoperative and post-operative complications were also recorded. Results In 37 patients, 34 cases got VAS score decrease in the lumbo-crural pain, and the pain relief time lasted more than 1 year. The total efifciency of modiifed Macnab evaluation is 91.89%, 3 cases with no obvious pain relief, including 1 case of intervertebral disc infection. Conclusion By the use of biplane DSA and its C-arm cone-beam CT imaging, ozone injection therapy for the lumbar disc herniation brings less trauma, less complications, and better analgesic effect.