腰椎旁神经阻滞加针刀脊神经触激术治疗重症腰椎间盘突出症的效果

Effect of Paravertebral Lumbar Nerve Block plus Acupotomy Spinal Nerve Stimulation in the Treatment of Severe Lumbar Disc Herniation

目的:探讨腰椎旁神经阻滞加针刀脊神经触激术治疗重症腰椎间盘突出症(LDH)的临床效果。方法:选取2021年1月—2023年9月景德镇市第一人民医院收治的重症LDH患者80例,按随机数字表法分为研究组与对照组,各40例。对照组采取腰椎旁神经阻滞,研究组在对照组基础上采取针刀脊神经触激术治疗。比较两组治疗效果、腰部活动度、疼痛程度[视觉模拟评分法(VAS)评分]、腰椎功能[日本骨科协会评估治疗(JOA)评分]及下肢麻木、安全性。结果:研究组治疗总有效率高于对照组(P<0.05);治疗后两组腰部前屈、后伸、侧屈活动度均大于治疗前,且研究组前屈、后伸活动度均大于对照组,JOA评分均高于治疗前,且研究组明显高于对照组(P<0.05);治疗后,两组疼痛VAS评分、麻木VAS评分均较治疗前降低,且研究组麻木VAS评分明显低于对照组(P<0.05);两组均无不良事件发生。结论:采用针刀脊神经触激术配合腰椎旁神经阻滞治疗重症LDH可有效缓解患者临床症状,并重建腰部功能,减轻腰部活动受限,并展现出高安全性。

Objective:To explore the clinical effect of paravertebral lumbar nerve block plus acupotomy spinal nerve stimulation in the treatment of severe lumbar disc herniation(LDH).Method:A total of 80 patients with severe LDH admitted to Jingdezhen No.1 People's Hospital from January 2021 to September 2023 were selected and divided into study group and control group according to random number table method,with 40 cases in each group.The control group was treated with paravertebral lumbar nerve block,and the study group was treated with acupotomy spinal nerve stimulation on the basis of the control group.The treatment effect,lumbar motion,pain degree[visual analogue scale(VAS)score],lumbar function[Japanese orthopaedic association(JOA)score],and lower limb numbness and safety were compared between the two groups.Result:The total effective rate of the study group was higher than that of the control group(P<0.05).After treatment,the motion of lumbar forward flexion,backward extension and lateral flexion in both groups were greater than those before treatment,and the motion of lumbar forward flexion and backward extension in the study group were greater than those in the control group,JOA scores were higher than those before treatment,and that in the study group was significantly higher than that in the control group(P<0.05).After treatment,the pain VAS scores and numbness VAS scores of both groups were lower than those before treatment,and numbness VAS score in the study group was significantly lower than that in the control group(P<0.05).No adverse events occurred in either group.Conclusion:Paravertebral lumbar nerve block combined with acupotomy spinal nerve stimulation in the treatment of severe LDH can effectively relieve the clinical symptoms,rebuild the lumbar function and reduce the restriction of lumbar movement,and show high safety.