椎间孔注射与改良硬膜外腔灌注治疗神经根型颈椎病的临床效果比较

Clinical Comparison of Intervertebral Foramen Injection and Improved Epidural Perfusion in the Treatment of Cervical Spondylotic Radiculopathy

目的:比较椎间孔注射与改良硬膜外腔灌注治疗神经根型颈椎病的临床效果。方法:选取2021年8月至2023年8月九江市第一人民医院接受注射治疗的神经根型颈椎病患者60例,采用随机数字法随机分成观察组和对照组,每组各30例,观察组采用DSA介导下精准椎间孔药物注射;对照组采用DSA介导下改良硬膜外腔药物灌注。比较两组穿刺时间、一次穿刺成功率、药液分布优良率以及安全性的统计学差异;随访并分析术后1h、1周、3个月时VAS评分、颈椎功能障碍指数(NDI)和总有效率的差别。结果:观察组术后1h的VAS评分低于对照组,对照组术后1周、术后3个月的VAS评分低于观察组,差异有统计学意义(P<0.05)。观察组术后1h的NDI低于对照组,对照组术后1周、术后3个月的NDI低于观察组,差异有统计学意义(P<0.05)。两组临床疗效比较,差异无统计学意义(P>0.05)。结论:椎间孔注射与改良硬膜外腔灌注治疗神经根型颈椎病的临床效果均较高,椎间孔注射能在早期减轻疼痛,促进颈椎功能恢复,而改良硬膜外腔灌注治疗的效果更为缓慢和持久。

Objective:To compare the clinical effect of intervertebral foramen injection and improved epidural perfusion in the treatment of cervical spondylotic radiculopathy.Methods:60 patients with cervical spondylosis of nerve root type who received injection therapy at the First People's Hospital of Jiujiang City from August 2021 to August 2023 were selected.Randomly divide into observation group and control group using random number method,with 30 cases in each group;The control group was treated with improved epidural drug perfusion mediated by DSA.The puncture time,the success rate of one puncture,the excellent rate of drug distribution and the safety of the two groups were compared;The VAS score,cervical dysfunction index(NDI)and total effective rate at 1H,1 week and 3 months after operation were followed up and analyzed.Results:The VAS score of the observation group at 1h after operation was lower than that of the control group,and the VAS score of the control group at 1 week and 3 months after operation was lower than that of the observation group,the difference was statistically significant(P<0.05).The NDI of the observation group at 1h after operation was lower than that of the control group,and the NDI of the control group at 1 week and 3 months after operation was lower than that of the observation group,the difference was statistically significant(P<0.05).There was no significant difference in clinical efficacy between the two groups(P>0.05).Conclusion:The clinical effect of intervertebral foramen injection and improved epidural perfusion in the treatment of cervical spondylotic radiculopathy is high.Intervertebral foramen injection can reduce pain and promote the recovery of cervical function in the early stage,while the effect of improved epidural perfusion is more slow and lasting.