经骶管与椎间孔注射糖皮质激素治疗腰椎管狭窄症所致坐骨神经痛疗效比较

Therapeutic effect of glucocorticoid for sciatic pain caused by lumbar spinal stenosis:caudal epidural injection versus transforaminal epidural injection

目的比较经骶管与椎间孔硬膜外注射糖皮质激素治疗腰椎管狭窄症所致坐骨神经痛的短期疗效。方法将48例腰椎管狭窄症伴有坐骨神经痛患者分为两组:骶管注射治疗(A组)18例,经椎间孔注射治疗(B组)30例。由同一组医生进行操作治疗,于注射后1周、3、6个月时采用视觉模拟评分法(VAS评分)、Oswestry功能障碍指数(ODI评分)比较两组患者的疗效。结果两组患者除注射1周后的VAS评分(P>0.05)外,注射后经椎间注射治疗组的VAS评分、ODI评分、疼痛缓解率及功能改善评分均优于经骶管注射治疗组(均P<0.05)。结论在腰椎管狭窄症伴坐骨神经痛的糖皮质激素治疗中,经椎间孔注射法的疼痛缓解及功能改善效果明显优于骶管注射法。

Objective To compare the short-term efficacy of caudal epidural steroid injection witiq transtoramLnal epidural injection of glucocorticoid for sciatic pain caused by lumbar spinal stenosis. Methods Forty eight patients with sciatic pain were randomly assigned to receive sacral steroid injection（group A, n=18） or transforaminal steroid injection （group B, n=30）. The visual analogue scale （VAS） and Oswestry disability index （ODI） were measured in two groups at 1 week, 3 months, and 6 months after injection, Results The VAS and ODI of transforaminal steroid injection were better than those of caudal steroid injection（P〈0.05） at all time points with the exception of VAS at 1 week after injection （P 〉0.05）. Conclusion Compared to caudal approach, transforaminal epidural injection of glucocorticoid has significantly better pain relief and functional improvement effect for patients with sciatic pain caused by lumbar spinal stenosis.