选择性神经根阻滞联合脉冲射频治疗不同病程腰椎间盘突出症临床效果评价

CLINICAL EFFICACY OF COMBINATION OF SELECTIVE NERVE ROOT BLOCK AND PULSE RADIO FREQUENCY TREATMENT ON DIFFERENT COURSES OF LUMBAR INTERVERTEBRAL DISC HERNIATION

目的：比较CT引导下选择性神经根阻滞联合脉冲射频治疗不同病程腰椎间盘突出症的临床疗效。方法：117例确诊为腰椎间盘突出合并椎间盘源性腰腿痛患者,根据不同病程分为3组：小于3月组（36例）、3~12月组（40例）和大于12月组（41例）,CT引导下对责任神经根行选择性神经根阻滞加脉冲射频治疗。应用疼痛视觉模拟评分（visual analogue scale,VAS）评价术前、术后1月、3月和12月的疼痛程度。结果：不同病程3组治疗后疼痛均不同程度缓解或消失,与术前VAS评分相比,术后1月、3月和12月的VAS评分均降低（P〈0.05）,术后1月、3月和12月三者间VAS差异无统计学意义（P〉0.05）。病程小于3月组治疗效果优于3~12月组和大于12月组（P〈0.05）。3~12月组和大于12月组间无统计学差异（P〉0.05）。结论：椎间盘突出所致腰腿痛急性期行选择性神经根阻滞联合脉冲射频治疗效果优于慢性期,有适应症的患者可选择早期治疗。

Objective： To evaluate efficacy of combination of CT-guided selective nerve root block and pulse radio frequency treatment on different courses of lumbar intervertebral disc herniation. Methods： I 17 patients with discogenic lumbocrural pain due to lumbar intervertebral disc herniation were enrolled in the study. According to the different courses, 117 patients were divided into three groups： less than 3 months group （36）, 3 ~ 12 months group （40） and longer than 12 months group （41）. Selective nerve root blocks combined with pulse radio frequency of their responsible nerve roots were completed under CT guidance. The visual analogue scale （VAS） was recorded at pre-operation and 1 month, 3 months and 12 months after operation respectively. Results： Compared with pre-operation, the VAS was decreased at 1 month, 3 months and 12 months after operation （P 〈 0.05）. There was no significant difference in VAS at 3 time points after operation. The clinical efficacy of less than 3 months group is better than 3-12 months group and longer than 12 months group （P 〈 0.05）. There was no statistical difference between 3 and 12 months group and greater than 12 months group （P 〉 0.05）. Conclusion： The clinical efficacy of combination of CT-guided selective nerve root block and pulse radio frequency treatment on acute stage of discogenic lumbocrural pain is better than chronic stage, patients with indication should choose early treatment.