背根神经节脉冲射频治疗退行性腰椎管狭窄症的疗效研究

Pulsed radiofrequency treatment of the dorsal root ganglion in patients with degenerative lumbar spinal stenosis

目的探讨背根神经节（dorsalrootganglion，DRG）脉冲射频治疗退行性腰椎管狭窄症的安全性和有效性。方法符合纳入和排除标准的退行性腰椎管狭窄症患者56例，均采用病变椎间隙双侧DRG脉冲射频调节。采用改良Macnab评分法分别于术后3、6、9、12个月随访评定疗效。结果56例患者术后3、6、9、12个月随访时优良率分别为89．2％、87．5％、67．8％、66．0％。术后9、12个月随访时优良率与术后3、6个月比较均有明显下降（P〈0．05）；术后3个月与6个月比较、9个月与12个月比较优良率差异无统计学意义（P〉0．05）。性别、年龄对疗效的影响差异无统计学意义（P〉0．05），病程及病变间隙的多寡对疗效有显著的影响，差异有统计学意义（P〈0．05）。本组病例均未发生严重并发症。结论DRG脉冲射频治疗退行性腰椎管狭窄症是安全有效的，半年之内效果较好。

Objective To evaluate the safety and clinical outcomes of pulsed radiofrequency neuromodulation to the dorsal root ganglion （DRG） in the treatment of degenerative lumbar spinal stenosis. Methods Fifty,ix patients with degenerative lumbar spinal stenosis meet the inclusion and exclusion criteria were enrolled in the study. All patients received bilateral pulsed radiofrequency neuromodulation at the affected lumbar intervertebral space. Clinical outcomes were evaluated by the Modified Macnab criteria at 3, 6, 9 and 12 months postoperatively. Results The successful （excellent and good outcome） rate was more than 85% at 3, 6 months and more than 65% at 9, 12 months, respectively （P〈0.05）. There was no major complication related to the procedure in all patients. Conclusions Pulsed radiofrequency neuromodulation to the DRG in the treatment of degenerative lumbar spinal stenosis is safe and effective, which can be an alternative treatment modality.