极外侧型腰椎间盘突出症MRI分析及射频消融手术疗效观察

Analysis of MRI and Therapeutic Effect of Radiofrequency Ablation of Extra-lateral Lumbar Disc Herniation

目的分析极外侧型腰椎间盘突出症(ELLDH)的MRI影像特征,并对应用椎间孔镜微创手术的疗效进行评估。方法收集2018年1月至2019年12月宁夏回族自治区中西医结合医院收治的60例ELLDH患者的临床资料进行分析,应用MRI分节段分析病变的分型及MRI征象;同时在应用经皮椎间孔镜技术治疗的术前、术后即时、术后1个月、术后6个月、术后1年分别进行功能障碍指数(ODI)与视觉疼痛模拟评分(VAS)的评估,疗效评估采用MacNab标准。结果60例ELLDH患者,腰椎间盘极外侧突出共累及72个腰椎间盘(24.0%),以腰3~4、腰4~5、腰5~骶1椎间盘突出为主;术后腰椎ODI指数和VAS腰痛评分、VAS腿痛评分均低于术前(P均<0.05);末次随访评估手术优44例、良13例,总有效率为96.7%。结论应用MRI能精准分析腰椎间盘极外侧突出的影像学特征,同时采用经皮椎间孔镜技术治疗ELLDH总有效率较高。

Objective To analyze the MRI imaging features of extra-lateral lumbar disc herniation(ELLDH),The effect of minimally invasive intervertebral foramen surgery was evaluated.Methods To collect the clinical data of 60 ELLDH patients admitted to the Ningxia Integrated Chinese and Western Medicine Hospital from January 2018 to December 2019,The classification and MRI signs of pathological changes were analyzed by MRI segmental analysis;The VAS scores of dysfunctions ODI index and visual pain were evaluated before,immediately after,1 month after,6 months after and 1 year after percutaneous foramen technique,MacNab criteria were used to evaluate the efficacy.Results A total of 72 lumbar intervertebral discs were involved in the lateral lumbar disc herniation(24.0%),lumbar 3-4,lumbar 4-5,lumbar 5-sacral 1 disc herniation;Postoperative lumbar ODI index and VAS low back pain score,VAS leg pain score compared with preoperative(P all<0.05);The last follow-up was performed in 44 cases,13 cases,The total effective rate was 96.7.Conclusion The MRI can accurately analyze the imaging features of the lateral protrusion of lumbar intervertebral disc;At the same time,the total efficiency of percutaneous intervertebral foramen ELLDH treatment is high.