侧后路经椎间孔镜下髓核摘除、射频热凝纤维环成形术治疗椎间盘源性腰痛

被引：45

作者：

吴闻文

李振宙

侯树勋

商卫林

机构：

[1] 解放军总医院第一附属医院骨科

来源：

中国脊柱脊髓杂志 | 2009年 / 19卷 / 06期

关键词：

椎间盘源性腰痛; 髓核摘除术; 射频; 内窥镜;

D O I：

暂无

中图分类号：

R687.3 [骨骼手术];

学科分类号：

100220 [骨科学];

摘要：

目的:观察侧后路经椎间孔镜下髓核摘除、射频热凝纤维环成形术治疗椎间盘源性腰痛的疗效。方法:2007年4月9月共收治经椎间盘造影证实的椎间盘源性腰痛患者25例,其中伴有下肢疼痛不适4例,术前腰痛VAS评分为6.24±0.97分,均采用侧后路经椎间孔镜下髓核摘除、射频热凝纤维环成形术治疗,术后1周、1个月、3个月、6个月和12个月时进行腰痛VAS评分,术后12个月时进行MacNab评分。结果:2例于术后1周出现下肢"日光烧灼综合征",均为L5/S1椎间盘纤维环破裂患者,经过脉冲电刺激治疗1周后缓解;无其他手术并发症发生。术前伴有下肢疼痛不适的4例患者术后下肢症状均缓解。随访12个月,术后1周腰痛VAS评分0.80±0.65分,术后1个月0.56±0.65分,术后3个月0.48±0.65分,术后6个月0.52±0.65分,术后12个月0.67±0.58分,术后各时间点评分较术前有明显降低（P<0.01）,术后6个月和12个月评分较术后1周无明显反弹（P>0.05）。按照MacNab评分标准,12个月随访时优11例,良12例,可2例,总有效率100%,优良率92%。结论:侧后路经椎间孔镜下髓核摘除、射频热凝纤维环成形术是治疗椎间盘源性腰痛的有效、微创方法。

引用

页码：403 / 407

页数：5

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