靶点射频消融联合神经阻滞治疗高龄患者退行性腰椎管狭窄症的疗效观察

Efficacy Observation of Target Radiofrequency Ablation Combined with Nerve Block in the Treatment of Elderly Degenerative Lumbar Spinal Stenosis

目的:探讨靶点射频消融联合神经阻滞治疗高龄患者退行性腰椎管狭窄症的临床效果。方法:回顾性分析2020年7月至2023年1月采用靶点射频消融联合神经阻滞治疗的19例高龄患者退行性腰椎管狭窄症。结果:本组手术时间为15~36 min,平均为20 min。无穿刺伤口感染、神经根损伤及椎管内出血等并发症。术前腰痛视觉模拟量表(VAS)评分为0~5分,平均为1.2分;下肢痛VAS评分为5~9分,平均为7.6分。术后即刻腰痛VAS评分为0~3分,平均为0.5分;下肢痛VAS评分为2~5分,平均为3.1分。术后3个月腰痛VAS评分为0~3分,平均为1分;下肢痛VAS评分为2~6分,平均为3.8分。19例均获随访,随访时间为3~7个月,平均为4.2个月。术后3个月采用改良MacNab疗效评定标准评价结果:优11例,良6例,可1例,差1例,优良率为89.47%。评定为可、差的2例患者最终接受椎间孔镜治疗,症状缓解。结论:靶点射频消融联合神经阻滞治疗高龄患者退行性腰椎管狭窄症,具有创伤小、近期疗效满意等优点。

Objective:To investigate the clinical efficacy of target radiofrequency ablation combined with nerve block in the treatment of elderly degenerative lumbar spinal stenosis.Methods:From July 2020 to January 2023,19 elderly patients with degenerative lumbar spinal stenosis who were treated with target radiofrequency ablation combined with nerve block were retrospectively analyzed.Results:The operation time was 1536 min,with an average of 20 min.There were no complications such as puncture wound infection,nerve root injury and intramural bleeding.Preoperative visual analogue scale(VAS)scores of low back pain were 05 points,with an average of 1.2 points,and VAS score of lower extremity pain was 59 points,with an average of 7.6 points.The VAS scores of immediate postoperative low back pain were 03 points,with an average of 0.5 points,and the VAS scores of lower extremity pain were 25 points,with an average of 3.1 points.Three months after surgery,the VAS scores of low back pain were 03 points,with an average of 1 points,and the VAS scores of lower extremity pain were 26 points,with an average of 3.8 points.All 19 cases were followed up from 3 to 7 months,with an average of 4.2 months.Three months after operation,the modified MacNab efficacy evaluation criteria were adopted:excellent 11 cases,good 6 cases,fair 1 case,poor 1 case,the excellent and good rate of 89.47%.Two patients rated fair or poor were eventually treated with foraminoscopy and their symptoms were relieved.Conclu-sion:Target radiofrequency ablation combined with nerve block in the treatment of elderly degenerative lumbar spinal stenosis has the advantages of less trauma and satisfactory short-term efficacy.