椎间盘内电热疗法治疗盘源性腰痛的疗效

Intradiscal electrothermal therapy for treating discogenic low back pain

目的探讨经皮椎间盘内电热治疗(IDET)对盘源性腰痛(DLBP)的临床疗效。方法对49例(49个病变椎间盘)DLBP患者行CT联合"C臂"X线机引导下IDET的治疗,其中Pfirrmann分级Ⅱ级26例,Ⅲ级23例。采用WHO疼痛缓解标准,将疼痛缓解程度分为无缓解、轻微缓解、部分缓解和完全缓解。结果对49个椎间盘均穿刺成功并行IDET治疗。术后1周及1、3和6个月随访,Ⅱ级、Ⅲ级两组患者疼痛缓解均随着术后时间的延长而逐渐明显,术后6个月时Ⅱ级患者有效率[88.46%(23/26)]高于Ⅲ级患者[60.87%(14/23),P<0.05]。术中、术后均未出现严重并发症。结论IDET治疗DLBP近期疗效较好,术后6个月时Pfirrmann分级为Ⅱ级的患者疗效优于Ⅲ级。

Objective To disscuss the effect of intradiscal electrothermal therapy（IDET）in treatment of discogenic low back pain.Methods The treatment results of 49cases（49sections）with discogenic low back pain who underwent IDET in CT and C arm X-ray guidance were retrospectively analyzed.According to the Pfirrmann classification,patients were divided into gradeⅡ（n=26）and gradeⅢ（n=23）.According to WHO criteria,the degree of pain relief was classified in to no remission,minute remission,partial remission and complete remission.Results All the 49 cases underwent IDET treatment successfully.Followed-up 1week,1month,3months,6months after treatment,pain relief of both grade became more and more obvious along with time prolonged.The effective rate was 88.46%（23/26）for gradeⅡ and 60.87%（14/23）for gradeⅢ（P〈0.05）6months after treatment.No major complications occurred during and after treatment.Conclusion IDET had good short term effects for treating discogenic low back pain,the effect of Pfirrmann gradeⅡ is superior to gradeⅢ at 6month after treatment.