选择性脊神经后支冷冻治疗腰背痛

CRYOTHERAPY OF SELECTIVE DORSAL RAMUS OF SPINAL NERVE FOR LUMBAR BACK PAIN

目的 :探讨选择性冷冻脊神经后支主干治疗腰背痛的疗效。方法 :依据病人主诉腰背痛部位 ,定出受累的脊神经后支 ,刺入冷冻针 ,以病人感到酸、胀、沉、困及轻度麻痛并向下传导至同侧臀、大腿及膝部示定位准确 ,送入冷冻液 ,一次 3个冻融周期。有多个痛点可分次进行。结果 :治疗12 9例 ,优良率 60 % ,有效率 88% ,以腰肌劳损及小关节紊乱症疗效最佳 ,优良率分别为 5 8%及84 % ,有效率达到 88%及 10 0 %。结论 :冷冻脊神经后支阻断了腰背痛的一部分传导通路从而起到止痛效果。术前病例选择 ,术中准确操作均是影响疗效的重要因素。

Objective: To explore the effect of freezing selective dorsal ramus of spinal nerve for low back pain. Methods: Depending on the location of low back pain, the real painful point and the dorsal ramus is identified. A freezing needle is inserted. If patient felt ache, swelling and heaviness and those feeling were conducted to buttock, thigh and knee but not to the leg, this position was accurate, and one can begin to freeze for three freeze cycles. The cryotherapy mas made according to the number of painful points. Results: 129 cases were treated. The total rate of excellent and good was 60%, effectiveness was 88%. A best result was obtained for the treatment of chronic injury of lumbar muscle and zygapophyseal joint disorder, with the rate of excellent and good of 58% and 84%, effectiveness rate 88% and 100% respectively. Conclusion: Cryotherapy on selective dorsal ramus of spinal nerve produces a relief of low back pain probably due to a partial block of pain conductance. Selection of patients before operation and the accurity of the operation are important factors derermining the efficacy of cryotherapy.