针具松解联合脉冲射频治疗腰椎间盘突出症术后后遗腰腿痛的临床疗效评价

Evaluation of the clinical effect of needle relaxation combined with pulsed radiofrequency in the treatment of lumbar and leg pain after the surgery of lumbar intervertebral disc protrusion

目的探讨针具松解联合脉冲射频治疗腰椎间盘突出症术后后遗腰腿痛的临床疗效。方法收集我科68例腰椎间盘突出症术后后遗腰腿痛患者,选择性应用针具（巨钩针、拨松针、椎间盘针）对腰椎椎管内外软组织进行针对性松解,同时对相应节段椎管侧隐窝区域责任神经根进行脉冲射频,之后椎间孔内口注射消炎镇痛液6~8 m L,每周1次,2次为1个疗程,观察患者治疗后的临床效果。结果与术前比较,疗程结束后即刻患者的VAS评分显著下降,疗程结束后1个月、3个月、6个月患者的VAS评分明显下降,差异均有统计学意义（P〈0.05）;疗程结束后1个月、3个月、6个月患者的总积分（JOA评分）与术前比较差异有统计学意义（P〈0.05）。结论腰椎间盘突出症术后后遗腰腿痛的原因涉及椎管内外的多发因素,采取针具松解联合神经根脉冲射频进行干预处理,具有良好的临床疗效。

Objective To study the clinical effect of needle relaxation combined with pulsed radiofrequency in the treatment of lumbar and leg pain after the surgery of lumbar intervertebral disc protrusion. Methods 68 patients with lumbar and leg pain after the surgery of lumbar intervertebral disc protrusion in our department were collected. Needles（giant crochet, pine needles, intervertebral disc needle） were selectively applied on internal and external soft tissue of lumbar spinal canal for targeted relaxation, while the responsible nerve root at the corresponding section of the spinal canal laterial recess was given pulsed radiofrequency. Afterwards, intervertebral foramen mouth was injected with 6-8 m L anti-inflammatory analgesic solution for once a week, with twice as a course of treatment. The clinical effect in the patients after treatment was observed. Results Compared with the preoperative period, the VAS score in the patients immediately after the end of treatment was decreased significantly, the VAS scores in the patients at 1 month, 3 months and 6 months after the treatment were significantly decreased, and the differences were all statistically significant（P〈0.05）;compared with the preoperative period, the differences of the total scores（JOA score） in the patients at 1 month, 3 months and 6 months after the end of treatment were statistically significant（P〈0.05）. Conclusion The causes of lumbar and leg pain after the surgery of lumbar intervertebral disc protrusion are related to multiple factors inside and outside the spinal canal. The application of needle relaxation combined with nerve root pulsed radiofrequency for intervention has a good clinical efficacy.