基于电磁引导的超声导航技术在腰椎等离子髓核成形术中的应用效果分析

Application effect analysis of electromagnetic navigation technology of ul-trasound-guided in lumbar plasma plasty of nucleus pulposus

目的探讨基于电磁引导的超声导航技术在腰椎等离子髓核成形术中的应用效果。方法选取2014年5~9月的56例腰椎间盘突出症患者作为研究对象,在超声导航下行侧后路腰椎间盘穿刺,观察术中情况及手术耐受性,记录手术并发症。结果 56例均顺利完成手术,以穿刺点与C型臂透视预设点间的距离〈5 mm为穿刺成功标准,穿刺到位率为91.3%（95/104）;以穿刺点与C型臂透视预设点间的距离〈4 mm为穿刺成功标准,穿刺到位率为89.4%（93/104）。超声导航的平均时间为（16.3±3.2）min。术后腰痛VAS评分从术前的（7.83±1.12）分下降到术后第1天的（2.41±0.84）分,末次随访时为（1.27±0.56）分,与术前比较,差异有统计学意义（t=2.391,P=0.023）。ODI评分由术前的（56.32±9.41）分下降到末次随访时的（8.61±3.41）分,差异有统计学意义（t=2.668,P=0.016）。在末次随访时的改良Macnab疗效评定中,优45例,良8例,可3例,优良率为94.64%（53/56）。结论基于电磁引导的超声导航技术在腰椎等离子髓核成形术中的应用到位率高,操作简便,疗效确切,减少了射线接触,安全性好。

Objective To explore the application effect of electromagnetic navigation technology of ultrasound-guided in lumbar plasma plasty of nucleus pulposus. Methods 56 cases with lumbar disc herniatio from May 2014 to September were selected and given the road of downstream lateral lumbar disc puncture in electromagnetic navigation technology of ultrasound-guided.The final needle tip position was checked with fluoroscopy.The intraoperative situation and operation tolerance was observed,and the operation complication was recorded. Results All operations were successfully performed.The success rate was 91.3%（95/104） when the limited average distance between fluoroscopy-designed and punctured points was 5 mm.The success rate was 89.4%（93/104） when the limited average distance between fluoroscopy-designed and punctured points was 4 mm.The average ultrasound-guided time was（16.3±3.2） min.The VAS score at preoperation was improved from（7.83±1.12） points to（2.41±0.84） points at the first day of postoperation,and the VAS score at last follow-up was（1.27±0.56） points,there was significant difference（t=2.391,P=0.023）.The ODI score was improved from（56.32±9.41） points at preoperation to（8.61±3.41） points at last follow-up,there was significant difference（t=2.391,P=0.023）.Evaluation of curative effect in the improvement of Macnab at the last follow-up,45 cases were excellent,8 cases were good,3 cases were general,the excellent and good rate was 94.64%（53/56）. Conclusion The application availability rate of electromagnetic navigation technology of ultrasound-guided in lumbar plasma plasty of nucleus pulposus is high,which is simple and effective,can reduce the radiation contact,has good security.