应用低温等离子髓核消融术治疗老年腰椎间盘突出症患者疗效及其病程的相关性研究

Correlation between the Disease Duration and the Curative Effect in Elderly Patients with Lumbar Disc Herniation Treated with Percutaneous Low- temperature Plasma Radiofrequency Ablation Nucleoplasty

目的研究应用低温等离子髓核消融术治疗老年腰椎间盘突出症患者疗效及其疼痛症状与病程的相关性。方法101例老年腰椎间盘突出症患者,采用经皮穿刺低温等离子髓核消融术进行治疗,采用改良Macnab疗效评定标准、JOA下腰痛评分及疼痛视觉模拟评分(VAS)量化评定治疗效果,在术前3天、术后3天、术后3个月3个时间点由患者根据自己情况进行填写。结果改良Macnab疗效评定标准在术后3天、3个月的优良率分别为74.3%和89.1%;JOA下腰痛评分及疼痛视觉模拟评分在术前3天与术后3天、术后3个月的比较差异均具有统计学意义(P<0.05);病程与术前3天JOA下腰痛评分没有明确的相关性;病程与术后3天和术前3天JOA下腰痛评分差值、病程与术后3个月疼痛视觉模拟评分和术前3天JOA下腰痛评分差值呈正相关,但未见显著相关性;病程与术前3天疼痛视觉模拟评分没有明确的相关性;病程与术后3天和术前3天疼痛视觉模拟评分差值、病程与术后3个月VAS和术前3天疼痛视觉模拟评分差值呈显著正相关;术前3天和术后3天JOA下腰痛评分评分呈显著正相关;术前3天与术后3个月及术后3天和术后3个月JOA下腰痛评分均呈正相关但未见明显相关性;术前3天和术后3天、术前3天与术后3个月的疼痛视觉模拟评分未见明显相关性;术后3天和术后3个月疼痛视觉模拟评分呈显著正相关。结论老年腰椎间盘突出症患者随着病程的增长,疼痛症状也有加重的趋势。应用低温等离子髓核消融术治疗老年腰椎间盘突出症患者近期和远期疗效良好,疗效较稳定,观察至术后3个月未见明显反复加重。病程是影响疗效的因素之一。

Objective To observe the correlation between disease duration,pain,and the curative effect of elderly patients with lumbar disc herniation treated with percutaneous low-temperature plasma radiofrequency ablation nucleoplasty.Methods We selected 101 cases of elderly patients with lumbar disc herniation,who underwent the treatment of percutaneous low-temperature plasma radiofrequency ablation nucleoplasty.We evaluated the treatment efficacy using modified Macnab evaluation criteria,JOA low back pain score and the pain visual analog scale assessment.Patients filled in these scales according to their own circumstances on before 3 days,after 3 days and after 3 months of surgery.Results After 3 days and after 3 months of surgery,the excellent and good rates of modified Macnab evaluation criteria were 74.3％ and 89.1％ respectively.JOA low back pain score and the pain visual analogue scale had statistical significance （P ＜ 0.05） on before 3 days compared with after 3 days and before 3 days compared with after 3 months.The disease duration had no clear correlation with JOA low back pain score of 3 days before the surgery.The disease duration and the score difference of JOA low back pain score before 3 days and after 3 days of the surgery was positively correlated but without significant correlation.The disease duration was positively correlated with the score difference of JOA low back pain score before 3 days and after 3 months of the surgery,but without significance.The disease duration had no clear correlation with pain visual analogue scale of 3 days before the surgery.The disease duration was positively correlated with the score difference of pain visual analog scale before 3 days and after 3 days of the surgery significantly.The disease duration was positively correlated with the score difference of pain visual analog scale before 3 days and after 3 months of the surgery significantly.Before 3 days and after 3 days of surgery,JOA low back pain scores were positively correlated significantly.Before 3 days and after 3 months of surgery,JOA low back pain scores were positively correlated but without significace.After 3 days and after 3 months of surgery,JOA low back pain scores were positively correlated but without significance.Before 3 days and after 3 days of surgery,the scores of pain visual analog scale had no clear correlation.Before 3 days and after 3 months of surgery,the scores of pain visual analog scale had no clear correlation.After 3 days and after 3 months of surgery,the scores of pain visual analog scale were positively correlated significantly.Conclusion With the growth of the disease duration,the pain of elderly patients with lumbar disc herniation is more severe.We use the methods of percutaneous low-temperature plasma radiofrequency ablation nucleoplasty to treat elderly patients with lumbar disc herniation,which can get short-term and long-term good efficacy and have stable efficacy.We found that the symptoms are stable after 3 months of surgery.The disease duration is one of the factors that affects the efficacy.