C臂机引导下经椎间孔选择性神经根封闭治疗腰椎间盘突出症临床效果观察

Clinical effect observation of transforaminal selective nerve root injection guided by a C-arm X-ray machine for the treatment of lumbar disc herniation

目的观察C臂机引导下经椎间孔选择性神经根封闭(TSNRI)治疗腰椎间盘突出症(LDH)的临床效果。方法选取2022年4-8月在上海市嘉定区中医医院骨伤科治疗的LDH患者52例作为研究对象,采用随机数表法将其分为观察组26例、对照组26例,观察组患者采用C臂机引导下经椎间孔神经根封闭治疗,对照组患者采用骶管封闭治疗。比较两组患者治疗前及治疗后视觉疼痛模拟评分(VAS)及Oswestry功能障碍指数。结果52例患者中2例失访,50例随访时间2~4个月,平均(2.25±0.17)个月,未出现感染病例,2例患者后期行脊柱内镜下髓核摘除术,1例患者后期行开放髓核摘除融合固定术,观察组患者在治疗后1、2个月VAS评分低于对照组,差异有统计学意义(P<0.05);观察组患者在治疗后1、2个月Oswestry评分低于对照组,差异有统计学意义(P<0.05)。结论C臂机引导下经椎间孔TSNRI治疗LDH,可以获得更好的疗效和更低的复发率,具有重要的临床价值和推广意义。

Objective To observe the clinical efficacy of transforaminal selective nerve root injection(TSNRI)guided by a C-arm X-ray machine for lumbar disc herniation(LDH).Methods A total of 52 LDH patients who were treated in the Department of Orthopedics and Traumatology of Jiading Hospital of Traditional Chinese Medicine in Shanghai from April to August 2022 were selected as the subjects.They were divided into an observation group of 26 cases and a control group of 26 cases using a random number table method.The patients in the observation group were treated with transforaminal selective nerve root injection guided by a C-arm X-ray machine,while the patients in the control group were treated with sacral canal block.The visual analogue scale(VAS)and Oswestry disability index between two groups of patients before and after treatment were compared.Results Among the 52 patients,2 were lost to follow-up,and 50 were followed up for 2-4 months(2.25±0.17)without any infection.2 patients underwent spinal endoscopic nucleus pulposus removal in the later stage,and 1 patient underwent open nucleus pulposus removal interbody fusion in the later stage.The VAS scores of patients in the observation group were lower than those of patients in the control group at 1 and 2 months after treatment,with statistical significance(P<0.05);The Oswestry scores of patients in the observation group were lower than those of patients in the control group at 1 and 2 months after treatment,with a statistically significant difference(P<0.05).Conclusion Transforaminal selective nerve root injection guided by a C-arm X-ray machine for the treatment of lumbar disc herniation can achieve better efficacy and lower recurrence rate,which has important clinical value and p romotion significance.