联合微创法个性化治疗腰椎间盘突出症的临床研究

Clinical Research on Personalized Treatment of Lumbar Intervertebral Disc by Combined Minimally Invasive Approach

目的：探讨联合微创法经皮穿刺臭氧和射频热凝治疗腰椎间盘突出症的方法和效果。方法腰椎间盘突出症50例，均在CT引导下后外侧入路，经皮穿刺针进入椎间盘中后1/3突出物靶点，然后依据个性化耐受程度和椎间盘病变情况，注入臭氧为50μg/mL（10～20 mL）再行髓核射频热凝，设定最高温度为90℃，时间为4个周期。结果该组病例在治疗后1周、3个月及6个月随访，1周内腰腿疼痛生活自理明显改善；3个月疼痛及下肢酸麻以及神经刺激征象均显著改善，甚至该征象消失，无1例并发症。结论联合微创法臭氧髓核化学溶解和射频热凝是治疗腰椎间盘突出症安全有效的一种方法。

Objective To discuss the methods and clinical effects of the treatment of protrusion of lumbar intervertebral disc by combination of percutaneous injection with ozone through minimal invasive surgery and radiofrequency thermo coagulation. Methods Fifty patients with protrusion of lumbar intervertebral disc were in-jected ozone （50μg/mL10～20 mL, which is according to individual tolerance level and intervertebral disc disor-ders） into the protrusion target, which was located in latter 1/3 section of intervertebral disc through poster lateral approach with CT-guidance. And then, nucleus pulposus radiofrequency thermo coagulation started with the high-est temperature 90℃. The time of duration is four cycles. Results The patients in this group had follow-up visits at one week, three months, and six months after the treatment. Lumbar and leg ache was improved within one week after treatment. Pain, numbness in lower limbs and nerve stimulation signs were improved observably within three weeks after the treatment. Even more, these signs were disappeared and no complication occurs. Conclu-sion The combination of percutaneous injection with ozone through minimal invasive surgery and radiofrequency thermo coagulation is the most effective method to treat protrusion of lumbar intervertebral disc.