经椎间孔镜窦椎神经射频消融术和经皮纤维环成形术治疗椎间盘源性腰痛的比较研究

Comparative Study of Radiofrequency Ablation and Percutaneous Annulus Fibroplasty on the Treatment of Discogenic Low Back Pain

目的:对比经椎间孔镜窦椎神经射频消融术和经皮纤维环成形术治疗椎间盘源性腰痛(DLBP)的疗效。方法:选择2019年1月至2019年11月西南医科大学附属医院的DLBP患者57例,随机分为观察组30例,常规组27例。观察组采用经椎间孔镜窦椎神经射频消融术,对照组采用常规经皮纤维环成形术。观察术前以及术后各个时间节点的VAS疼痛评分、ODI、JOA评分以及血清P物质(SP)水平。结果:观察组在术后6个月、术后12个月的VAS疼痛评分、ODI和JOA评分均优于对照组,差异有统计学意义(P<0.05)。而在SP方面,在术后3个月、6个月和12个月,观察组SP水平均低于对照组,差异有统计学意义(P<0.05)。两组术后VAS评分、ODI、JOA评分较治疗前好转,且差异有统计学意义(P<0.05)。结论:经椎间孔镜窦椎神经射频消融治疗DLBP,能缓解患者的疼痛和功能障碍,远期疗效优于纤维环成形术。

Objective:To compare the efficacy of radiofrequency ablation and percutaneous annulus fibroplasty on the treatment of discogenic low back pain.Methods:57patients with DLBP from January 2019to November 2019were randomly divided into observation group(30cases)and routine group(27cases).The observation group was treated with radiofrequency ablation of endoscopic sinus vertebral nerve through intervertebral foramen,and the control group was treated with conventional percutaneous annulus fibroplasty.VAS pain scores,ODI,JOA scores and serum substance P(SP)level were observed before and after operation.Results:The VAS pain scores,ODI and JOA scores of the observation group at 6and 12months after operation were better than those of the control group(P<0.05).In terms of SP,the level of SP in the observation group was lower than that in the control group at 3,6and 12months after operation(P<0.05).Conclusion:Radiofrequency ablation of endoscopic sinus vertebral nerve through intervertebral foramen can effectively alleviate the pain and dysfunction of patients,and the long-term efficacy is better than that of annulus fibroplasty.