髓核成形术治疗腰腿痛患者的选择(附45例临床初步报告)

The option of nucleoplasty for treating patients with low back and leg pain

目的:探讨髓核成形术治疗腰腿痛患者的最佳适应证。方法:应用髓核成形术治疗45例腰腿痛患者,男26例,女19例,平均年龄32岁(18~46岁),病程平均2年(5个月~4年),其中腰痛伴有下肢放射痛40例。手术前先进行椎间盘造影,然后行髓核成形术治疗,比较手术前后疼痛症状并进行疗效评定。结果:术后随访3~20个月,平均12个月。优良率为80%(36例);腰痛伴有下肢放射痛者有效率为85%;椎间盘造影阳性者有效率为92%。无效8例,术后加重1例。结论:在下列情况下应用髓核成形术治疗腰腿痛患者将提高临床的有效率:(1)腰痛伴有下肢放射痛症状的患者;(2)影像学上表现为侧方小的椎间盘突出,以神经根刺激症状为主要症状者;(3)椎间盘造影阳性的患者。

Objective:To identify the best indications of nucleoplasty in treating patients with low back and leg pain.Method:Forty-five patients with low back pain(40 cases of them with leg pain at same time) were treated with nucleoplasty and were followed up for average 12 months(range 3~20 months) postoperatively.Their average age was 32 years old(18~46),average duration was 2 years(5 months^4 years).The data collected was analyzed via comparing pain changed preoperatively and postoperatively.Result:Total effective rate was 80% (36 cases).The effective rate was 85% in patients with leg pain at same time.The effective rate was 92% in patients with positive discography.8 cases were ineffective.The pain became severe postoperatively in only one case.Conclusion:The clinical factors favoring results of nucleoplasty for treating patients with low back and leg pain include:(1)Patients with low back pain and reflecting leg pain.(2)Lateral and small nucleus pulposus herniation and leg pain is the major symptom.(3)Discography is positive.