经皮穿刺射频热凝术与后路椎管减压突出髓核摘除术治疗椎间孔型腰椎间盘突出症临床疗效比较

Comparison of the clinical curative effect between percutaneous radiofrequency thermocoagulation and intervertebral discectomy with spinal posterior decompression in the treatment of lumbar intervertebral foraminal disc protrusion

目的探讨经皮穿刺射频热凝术在治疗椎间孔型腰椎间盘突出症的临床疗效。方法 69例临床诊断为椎间孔型腰椎间盘突出症患者,将其分成两组,治疗组采用C臂引导下经皮穿刺进入突出椎间盘靶点位置射频热凝术治疗;对照组采用后路椎管减压突出髓核摘除术治疗,比较两组间治疗效果差异。采用疼痛视觉模拟评分法(VAS)及日本骨科学会(JOA)下腰痛评分标准,以治疗前后的分值计算改善率。结果优良率80%。其中优18例(45%),良14例(35%),可6例(15%),差2例(5%)。结论经皮穿刺射频热凝术治疗椎间孔型腰椎间盘突出症是安全、有效的,具有损伤小、疼痛缓解快、并发症少、患者依从性好的特点。

Objective To investigate the clinical efficacy of the percutaneous radiofrequency thermocoagulation in the treatment of lumbar intervertebral foraminal disc protrusion. Methods 69 patients with lumbar intervertebral foraminal disc protrusion were divided into two groups. The treatment group was given radiofrequency thermocoagulation via percutaneous puncture into the protrusion site under the guidance of C-arm. The control group was given intervertebral discectomy with spinal posterior decompression. Treatment effects of the two groups were compared. Visual analogue scale（VAS） and Japanese Orthopaedic Association（JOA） scoring criteria of lower back pain were used to evaluate the improvement, and the scores before and after treatment were used to calculate the improvement rate. Results The excellent and good rate was 80%. Among them,18 cases were excellent（45%）,14 cases were good（35%）,6 cases were fair（15%）,2 cases were poor（5%）. Conclusion Percutaneous radiofrequency thermocoagulation is safe and effective for treating lumbar intervertebral foraminal disc protrusion. It has the characteristics of less injury,fast pain relief, fewer complications and good patients compliance.