椎间孔镜下脊神经后支射频消融术治疗腰椎关节突关节源性腰腿痛的效果

Clinical Effect of Transforaminal Endoscopic Radiofrequency Neurotomy of Posterior Branch of Spinal Nerve in the Treatment of Lumbar Zygapophysial Joint-Derived Low Back and Leg Pain

目的探讨椎间孔镜下脊神经后支射频消融术治疗腰椎关节突关节源性腰腿痛患者的临床效果,并分析其对腰椎功能的影响。方法选取2019年10月至2020年10月于开封市中医院接受椎间孔镜下脊神经后支RN治疗的58例腰椎关节突关节源性腰腿痛患者作为研究对象。根据治疗方案分为观察组(n=29)、对照组(n=29)。对照组接受针刀治疗,观察组接受椎间孔镜下脊神经后支射频消融术治疗。比较两组临床效果、术前与术后2个月炎症介质[肿瘤坏死因子(TNF-α)、白介素-1β(IL-1β)]水平、术前与术后6个月疼痛程度[视觉模拟量表(VAS)]、腰椎功能[日本骨科协会(JOA)评估量表]及手术满意度。结果观察组总优良率[93.10%(27/29)]高于对照组[68.96%(20/29)](P<0.05);同对照组比较,术后6个月观察组VAS评分较低,JOA评分较高(P<0.05);观察组总满意度[96.55%(28/29)]高于对照组[79.31%(23/29)](P<0.05)。结论与常规治疗相比,对腰椎关节突关节源性腰腿痛实施椎间孔镜下脊神经后支射频消融术治疗效果较好,能有效减轻患者疼痛,利于恢复腰椎功能,改善患者生活质量,提高患者术后满意度。

Objective To investigate the clinical effect of transforaminal endoscopic radiofrequency neurotomy of posterior branch of spinal nerve in the treatment of lumbar zygapophysial joint-derived low back and leg pain,and to analyze the effect on lumbar spine function.Methods A total of 58 patients with lumbar zygapophysial joint-derived low back and leg pain who underwent transforaminal endoscopic radiofrequency neurotomy of posterior branch of spinal nerve in Kaifeng Hospital of Traditional Chinese Medicine from October 2019 to October 2020 were selected as the research objects.According to treatment plans,they were divided into observation group(n=29)and control group(n=29).The control group was treated with acupotomy,and the observation group was treated with transforaminal endoscopic radiofrequency neurotomy of posterior branch of spinal nerve.The clinical effects,pain degree[visual analog scale(VAS)],lumbar function[estimated by Japanese Orthopedic Association(JOA)assessment scale]and satisfaction before and after operation were compared between the two groups.Results The total excellent and good rate of observation group was 93.10%(27/29),higher than that of control group[68.96%(20/29)](P<0.05).Compared with control group,the VAS score of observation group was lower,and the JOA score was higher at 6 months after operation(P<0.05).The total satisfaction of the observation group[96.55%(28/29)]was higher than that in the control group[79.31%(23/29)](P<0.05).Conclusion Compared with conventional treatment,the effect of transforaminal endoscopic radiofrequency neurotomy of posterior branch of spinal nerve for lumbar zygapophysial joint-derived low back and leg pain is significant,which can effectively reduce the patient’s pain,restore lumbar function,improve the quality of life and satisfaction after surgery.