射频消融髓核成形术治疗颈椎间盘突出症临床分析

Clinic analysis on treatment of cervical disc herniatioherniation with radiofrequency ablation and nucleus pulposus keraton keratoplasty

目的:通过回顾病例,总结分析射频消融髓核成形术治疗颈椎间盘突出的临床疗效。方法:回顾分析2011年6月—2013年8月我科收治的16例颈椎间盘突出症患者,年龄44～73岁,平均年龄54.6岁,均应用或辅助使用射频消融髓核成形术进行治疗。用年龄及Miyazaki椎间盘退变程度分级确定责任间盘。按Macnab评定标准及VAS评分系统进行疗效评估。结果:单纯行射频消融或联合椎间盘切吸术平均时间40.5 min。平均出血量为2.3 ml,2例开放性手术的出血量均为50 ml。住院时间4～15天。随访时间6～28个月。术后3个月与术后1天疼痛VAS评分比较,差异显著(P=0.041)。依据Macnab标准:优10例,良5例,可1例,优良率93.8%。结论结论:射频消融髓核成形术治疗神经根性颈椎间盘突出症疗效确切,而对于混合型颈椎病可作为辅助治疗手段,一定程度上能缓解部分临床症状。

Objective:Clinic effect of treatment of cervical disc herniation with radiofrequency ablation and nucleus pulposus keratoplasty was analysed retrospectively. Methods:16 cases of cervical disc herniation from 2011 June to 2013 August in our department were treated by radiofrequency ablation and nucleus pulposus keratoplasty, the age was from 44 to 73, the average age was54.6. The main disc was fixed by ages and Miyazaki disc degeneration levels. The effect was analysed by Macnab standards and VAS scoring system. Results:The average operation time of radiofrequency or combined lumbar discectomy was 40.5 mins, the average amount of bleeding was 2.3 ml,the amount of bleeding except 2 cases of open operation were 50 ml. The hospitalization time was 4～15 days. The follow-up time was 6～28 months. The VAS scores of 3 months post-operation and 1 day post-operation had significant difference(P=0.041). On the basis of Macnab standard: excellent in 10 cases, good in 5 cases, ordinary 1 case, the excellent and good rate was 93.8%. Conclusion:The treatment effect of cervical disc herniation with radiofrequency ablation and nucleus pulposus keratoplasty was obvious, while for the mixed type of cervical spondylosis, this method can be used as an adjuvant therapy,and alleviate clinical symptoms at certain levels.