CT引导下脊髓射频热凝术治疗脊髓损伤继发性神经病理性疼痛的有效性和安全性

Efficacy and safety of CT-guided radiofrequency spinal surgery treatment of spinal cord injury secondary neuropathic pain

目的:评价CT引导下行脊髓射频热凝术治疗脊髓损伤继发性神经病理性疼痛的疗效及安全性。方法:2011年1月至2012年10月间脊髓损伤继发性神经病理性疼痛患者68例行CT引导下脊髓射频热凝术,评价治疗效果、疼痛评分(VAS)及不良反应发生情况。结果:患者治疗后3个月、6个月、1年和2年的总有效率逐渐提高,治疗2年68例患者均获得治愈或有效,未见无效病例。患者治疗后VAS评分较治疗前显著降低,且随着随访时间的延长,VAS评分不断下降,治疗后各时间点的VAS与治疗前比较有统计学意义(P<0.01)。68例患者中2例出现轻度腹痛,2例出现浅感觉减退,1例有硬膜刺破后头痛,但均未经处理自行恢复,不良反应率为7.4%,患者未出现脑脊液漏、手术相关合并症等。结论:CT引导下应用脊髓射频热凝技术治疗脊髓损伤继发性神经病理性疼痛具有较好的有效性及安全性,治疗时应严格把握适应征,并掌握手术技巧。

Objective： To evaluate the efficacy and safety of CT - guided radiofrequency spinal surgery treatment of spinal cord injury secondary neuropathic pain. Methods： Al l 68 patients w ith spinal cord in ju ry secondary neuropathic pain from January 2011 to October 2012 were given CT - guided radiofrequency spinal surgery,treatment effect,pain scores （VAS） and the incidence of adverse reactions were evaluated. Results ： The total effective rate of patients 3 months,6 months, 1 year and 2 year after treatment gradually increased,treatment for 2 years all 68 cases of patients were cured or effective. VAS scores of patients after treatment were significantly lower than before treatment, and with the extended follow - up time, VAS scores were declining, VAS at each time point after treatment compared with no pre - treatment was statistically significant（P 〈 0. 01 ）. 2 cases in 68 patients had mild abdominal pain,2 cases ap-peared shallow hypoesthesia, 1 case was dural puncture headache, but were untreated self - healing, adverse reaction rate was 7.4% ,patients did not occur cerebrospinal fluid leakage,surgery - related complications. Conclusion： CT - guided radiofrequency spinal surgery treatment of spinal cord injury secondary neuropathic pain is with good efficacy and safety, treatment should strictly control the indications, and master surgical skills.