低温等离子射频消融术联合SGB治疗伴交感神经症状颈椎病的疗效评价

Effect of low-temperature plasma radiofrequency ablation combined with SGB in the treatment of cervical spondylosis with sympathetic symptoms

目的:评价CT引导下低温等离子射频消融术联合超声引导下星状神经节阻滞(stellate ganglion block,SGB)治疗伴交感神经症状颈椎病的临床疗效和安全性。方法:回顾性分析伴交感神经症状颈椎病病人73例临床资料,其中单纯行低温等离子射频消融术病人(A组)42例,行低温等离子射频消融术联合SGB病人(B组)31例。比较2组病人的一般资料、视觉模拟评分(visual analogue scale,VAS)、日本骨科协会评分(Japanese Orthopaedic Association scores,JOA)、交感神经症状评分、临床疗效以及并发症发生情况。结果:2组病人治疗前的VAS评分、JOA评分和交感神经症状评分差异无统计学意义(P>0.05);B组治疗后1、4周的VAS评分和治疗后1、4、12周的交感神经症状评分均低于A组(P<0.05~P<0.01),治疗后1、4周的JOA评分均高于A组(P<0.05和P<0.01)。治疗后12周,A组治疗总优良率为85.71%(36/42),与B组的87.10%(27/31)差异无统计学意义(P>0.05)。2组均无明显并发症发生。结论:低温等离子射频消融术联合SGB治疗伴交感神经症状颈椎病,有助于改善病人症状,促进病人康复,具有一定临床价值。

Objective:To evaluate the clinical efficacy and safety of CT-guided low-temperature plasma radiofrequency ablation combined with ultrasound-guided stellate ganglion block(SGB)for cervical spondylosis with sympathetic symptoms.Methods:The clinical data of 73 patients with cervical spondylosis with sympathetic symptoms were analyzed retrospectively,including 42 patients who underwent low-temperature plasma radiofrequency ablation alone(group A)and 31 patients who underwent low-temperature plasma radiofrequency ablation combined with SGB(group B).The general data,visual analogue scale(VAS),Japanese Orthopaedic Association scores(JOA),sympathetic symptom scores,clinical efficacy and complications were compared between the two groups.Results:There was no significant difference in VAS score,JOA score and sympathetic symptom scores between the two groups before treatment(P>0.05).The VAS scores of group B at 1 and 4 weeks after treatment and the scores of sympathetic symptoms at 1,4 and 12 weeks after treatment were lower than those of group A(P<0.05 to P<0.01),and the JOA scores at 1 and 4 weeks after treatment were higher than those of group A(P<0.05 and P<0.01).At 12 weeks after treatment,the overall excellent and good rates of group A and group B were 85.71%(36/42)and 87.10%(27/31),respectively,and the difference of which was not statistically significant(P>0.05).There was no obvious complication in each group.Conclusions:Low-temperature plasma radiofrequency ablation combined with SGB in the treatment of cervical spondylosis with sympathetic symptoms is helpful to improve patients′symptoms and promote patients′rehabilitation.It has certain clinical value.