等离子射频联合臭氧髓核成形术治疗顽固性椎间盘源性腰痛的疗效观察

The effect of the plasma radiofrequency ablation combined with ozone nucleoplasty in the treatment of intractable discogenic pain

目的：探讨低温等离子复合臭氧髓核消融术治疗椎间盘源性腰痛的有效性与安全性。方法：选择微创手术治疗椎间盘源性腰痛患者80例，随机分为等离子射频联合臭氧髓核成形术组（ A组）和单纯等离子射频髓核成形术组（ B组）各40例，随访观察治疗效果。采用视觉模拟评分（ VAS）观察疼痛的变化，下腰痛日本骨科协会（ JOA）评分标准与改良Macnab评定系统评价术后临床效果。结果：所有患者髓核消融治疗均顺利完成，治疗期间无脊髓、神经根损伤、椎间隙感染等并发症。 A组患者术后3个月JOA评分及VAS评分均优于B组（P〈0.05~P〈0.01）。 A组术后3个月的临床效果与B组差异无统计学意义（P〉0.05）。结论：低温等离子射频复合臭氧消融术治疗椎间盘源性腰痛能达到较为满意的短期临床疗效，是一种安全有效的微创治疗方案。

Objective：To explore the efficacy and safety of the plasma radiofrequency ablation combined with ozone nucleoplasty in the treatment of intractable discogenic pain. Methods：Eighty patients with discogenic pain were randomly divided into the plasma radiofrequency ablation combined with ozone nucleoplasty group（ A group） and simple plasma radiofrequency ablation combined with ozone nucleoplasty（B group）（40 cases each group）. The treatment efficacy in two groups were observed. The pain and clinical effect in two groups after operation were evaluated using visual analog scale（ VAS） ,and Japanese orthopaedics association（ JOA） low back pain score and modified Macnab evaluation criteria,respectively. Results：The nucleoplasty in all patients were successful completed,and no spinal cord and nerve root injury,intervertebral space infection were found. The scores of VAS and modified JOA in A groups after 3 month of operation were better than that in B group（P〈0. 05 to P〈0. 01）. The excellent and good rates in A group after 3d and 3month of operation were better than those in B group. Conclusions：The short-peroid clinical effect of the low temperature plasma radiofrequency ablation combined with ozone nucleoplasty in the treatment of discogenic pain is good,which is a kind of safe,effective and minimally invasive treatment.