脊神经后内侧支连续射频联合坐位旋推手法治疗小关节源性下腰痛的临床疗效

Clinical Efficacy of Continuous Radiofrequency Combined with Sitting Rotation-pushing Manipulation of Spinal Nerve Posterior Branch in Treatment of Small Articular Low Back Pain

目的:观察脊神经后内侧支连续射频联合坐位旋推手法治疗小关节源性下腰痛的临床疗效。方法:选择2015年12月—2018年12月就诊于天津中医药大学第一附属医院骨伤科的腰椎小关节源性LBP患者共180例。其中连续射频联合坐位旋推手法组90例(射频+手法组),单纯连续射频组90例(射频组),观察并比较治疗前后疼痛视觉模拟(VAS)评分、Oswestry功能障碍指数(ODI)评分、日本骨科协会(JOA)评分、SF-36生活质量评分及腰部软组织张力变化,并评价临床疗效。结果:射频+手法组总有效率(97.78%)优于射频组总有效率(92.22%),差异有统计学意义(P<0.05);两组VAS、ODI、JOA、SF-36评分及腰部软组织张力组内与治疗前比较,治疗后较治疗前明显改善,差异有统计学意义(P<0.05),两组治疗后组间比较,射频+手法组优于单纯射频组,差异有统计学意义(P<0.05)。结论:脊神经后内侧支连续射频联合坐位旋推手法在改善患者下腰痛、软组织张力、腰椎功能及生活质量方面疗效显著,值得推广。

Objective To observe the clinical effect of continuous radiofrequency of posterior medial branch of spinal nerve combined with sitting rotation manipulation in the treatment of facet arthrogenic low back pain.Methods A total of 180 cases were included in the study using retrospective cohort study,including 90 cases in the continuous RF combined with sitting rotation maneuver group(RF+maneuver group)and 90 cases in the simple continuous RF group(RF group).Visual analog pain(VAS)score,Oswestry disability index(ODI)score,Japanese Orthopaedic Association(JOA)score,SF-36 quality of life score and lumbar soft tissue tension were observed before and after treatment.Intra-group and intergroup statistical analysis were performed and the clinical efficacy was evaluated.Results The total effective rate of the RF+manipulation group(97.78%)was better than that of the RF group(92.22%)and the difference was statistically significant(P<0.05).The VAS,ODI,JOA,SF-36 scores and lumbar soft tissue tension in the two groups were significantly improved after treatment compared with those before treatment(P<0.05).The comparison between the two groups after treatment showed that the radiofrequency+manipulation group was better than the radiofrequency alone group(P<0.05).Conclusion The continuous radiofrequency of the posterior medial branch of spinal nerve combined with sitting rotation manipulation has a significant effect on the improvement of patients’low back pain,soft tissue tension,lumbar function and quality of life,which is worthy of promotion.