【摘要】 目的:探讨经椎间孔入路射频热凝术治疗腰椎间盘突出症临床疗效及其与突出物大小变化相关性。方法:329例腰椎间盘突出症(单间隙侧后型突出)行椎间盘靶点射频热凝术的患者,术后3月、6月、12月,采用日本骨科协会(JOA)下腰痛疾患疗效判定标准评定术后疗效,术后12月随访到的患者中随机抽取30例行腰椎间盘CT检查,采用椎间盘突出指数评定计算突出物大小,分析突出物大小变化率与JOA评分改善率相关关系。结果:所有患者术中、术后均未出现严重副作用。术后3月、6月、12月分别随访到329例、270例、224例患者,各时间点优良率分别分72.64%,69.26%,73.66%;三个时间点优良率比较χ2=1.125(p=0.57),各随访时间点优良率差异常无统计学意义。术后JOA评分改善率及突出物大小变化率Rs=0.092(P>0.05)。结论:经椎间孔入路椎间盘靶点射频热凝术是治疗腰椎间盘突症的一种安全、有效方法,其临床疗效与突出物大小变化无明显相关关系。更多还原

【Abstract】 Objective:To study the relationship between the therapeutic effect of percutaneous transforaminal lumbar disc radiofrequency thermocoagulation and the size reduction of disc herniation.Methods: 329 patients with single lateral lumbar disc herniation were treated with percutaneous transforaminal lumbar disc radiofrequency thermocoagulation,whose effect were assessed by the current Japanese Orthopaedic Association(JOA) scoring system at 3,6,12 months post-operation.Thirty patients were recruited to undergo lumbar spine CT,with the size of disc herniation calculated by disc herniation index.The relationship between the therapeutic effect of percutaneous transforaminal lumbar disc radiofrequency thermocoagulation and the reduction ratios of herniation size was analysed.Results:There were no serious side effects occurred in this study.329,270 and 224 cases were followed up at 3,6,12 months post-operation,the excellent and good rates were 72.64%,69.26%,73.66%,respectively.No significant difference was observed in the three ratios(χ2=1.125,p=0.57).Spearman correlation analysis showed the effectiveness of treatment had no relationship with the reduction ratios of herniation size(Rs=0.092,P>0.05).Conclusion: percutaneous transforaminal lumbar disc radiofrequency thermocoagulation is safe and effective in treatment of lumbar disc herniation.There is no relationship between the effectiveness of treatment and the reduction ratios of herniation size.更多还原