射频热凝联合硬膜外阻滞治疗腰椎间盘突出症对患者腰痛、功能障碍的改善及MRI影像学变化观察

Radiofrequency Thermocoagulation Combined with Epidural Block in the Treatment of Lumbar Disc Herniation Improves Patients with Low Back Pain and Dysfunction and MRI Imaging Changes

目的分析射频热凝联合硬膜外阻滞热敏治疗腰椎间盘突出症对患者腰痛、功能障碍的改善及核磁共振(MRI)影像学的影响。方法本院2017年3月~2018年11月收治的64例腰间盘突出患者,通过计算机产生随机数将其分为对照组和观察组,每组各32例。对照组给予硬膜外阻滞治疗,观察组行硬膜外阻滞联合射频热凝治疗,并随访1年。比较2组治疗前、治疗后1个月视觉模拟评分法(VAS)评分、日本骨科协会(JOA)评分、椎间盘MRI形态测量值;治疗过程中症状消失时间;1年后2组疗效。结果随访1年后,观察组的总有效率为93.75%,组间更高(71.86%,P<0.05)。治疗后,两组JOA评分均升高,观察组相对更高(P<0.05);VAS评分均降低,且观察组相对更低(P<0.05)。治疗后,观察组患者椎间盘的膨出程度和脱出程度均显著低于对照组(P<0.05)。观察组患者腰部、下肢的疼痛感、酸楚感消失时间均更短(P<0.05)。结论在神经阻滞基础上,应用射频热凝对腰间盘突出症治疗效果较好,可迅速缓解患者临床症状,减轻疼痛及功能障碍,MRI观察椎间盘形态也有所改善。

Objective To analyze the effect of radiofrequency thermocoagulation combined with epidural block thermotherapy on the treatment of lumbar disc herniation on patients with low back pain,dysfunction and magnetic resonance imaging(MRI).Methods 64 patients with lumbar disc herniation treated in our hospital from March 2017 to November 2018 were divided into the control group and the observation group by computer-generated random numbers,32 cases in each group.The control group was given epidural blockade treatment.The observation group was combined with radiofrequency thermocoagulation treatment on the basis of the control group.Both groups were followed up for 1 year.The scores of visual analogue scale(VAS),the Japanese Orthopaedic Association(JOA),and the MRI morphological measurements of the intervertebral discs before and after treatment;the symptom disappearance time during treatment;and the efficacy after 1 year were compared between the 2 groups.Results After 1 year of follow-up,the total effective rate in the observation group was 93.75%,which was significantly higher than that in the control group,71.86%(P<0.05).After treatment,the JOA scores of both groups increased,and the observation group was higher than the control group(P<0.05);the VAS scores decreased,and the observation group was lower than the control group(P<0.05).After treatment,the degree of disc bulging and prolapse in the observation group were significantly lower than those in the control group(P<0.05).The pain and soreness of the waist and lower limbs of the observation group were shorter than those of the control group(P<0.05).Conclusion On the basis of nerve block,the application of radiofrequency thermocoagulation has a good effect on the treatment of lumbar disc herniation.It can quickly relieve patients'clinical symptoms,relieve pain and dysfunction.MRI observation of disc morphology has also improved.