【摘要】 目的研究应用小关节内侧缘入路,联合注射臭氧与胶原酶,治疗巨大型(突出物长径>5 mm)腰椎间盘突出症的效果、并发症及不良反应。方法36例腰椎间盘突出症患者,于CT引导下穿刺,穿刺针经小关节内侧缘进入硬膜外间隙、突出物内及椎间盘中后1／3处,在盘内注射浓度为60μg/ml的臭氧10 ml,突出物内注入胶原酶600 U水溶液1 ml和浓度为60μg／ml的臭氧5 ml,硬膜外间隙神经根旁注入浓度为40μg／ml的臭氧10 ml和得保松7 mg。结果治疗3个月后进行随访,按照改良Macnab方法进行评定,优20(55．6％)例,良14(38．9％)例,差2(5．5％)例,有效率94．4％。治疗过程全部患者无严重疼痛及症状加重,无脊髓、硬膜囊、血管、神经等重要脏器损伤。结论该方法在CT引导下操作,定位准确,穿刺顺利,成功率100％,无不良反应及严重并发症,是一种安全有效的对巨大型腰椎间盘突出症的治疗方法。同时为髂骨翼较高、横突肥大的L5-S1椎间盘突出症患者,行侧后方盘内穿刺进针困难者,提供了一种更安全、更方便的进针入路。更多还原

【Abstract】 Objective To study the clinical efficacy,complications and side effects of ozone and collagenase injected through inner margin of facet joint in the treatment of huge lumbar intervertebral disc hemiation (>5mm). Methods 36 patients suffering from huge lumbar intervertebral disc hemialion were reported. Guided by CT puncture was performed through inner margin of facet joint. Ozone 10 ml (60μg/ml) was injected into intervertebral disc,collagenase 1 ml(600 U/ml) and ozone 5 ml(60μg/ml)were injected into protuberance and ozone 10 ml (40μg/ml) and diprospan 7 mg were injected around nerve root in epidural space. Result The clinical results were assessed according to improved Macnab method 3 months after treatment. In all patients 20 cases(55. 6% ) were excellent, 14 cases(38. 9% ) good, only 2 cases (5.5% )poor. The effective rate was 94. 4(34 cases). There were no severe pain,aggravated symptoms or injuries of important organs (including spinal cord, dura sac, vessels and nerves ). Conclussion This puncture route with CT guidance is accurate localization and easy manipulation for the treatment of huge lumbar intervertebral disc hemiation and has no side effects or severe complications.更多还原