等离子髓核成形术联合选择性神经根阻滞治疗腰椎间盘突出症疗效分析

CLINICAL REPORT OF NUCLEOPLASTY COMBINED WITH SELECTIVE NERVE ROOT BLOCK FOR TREATING PATIENTS WITH LUMBAR DISC HERNIATION

摘要:

目的：探讨等离子髓核成形术联合选择性神经根阻滞治疗腰椎间盘突出症的疗效.方法：选择70例腰椎间盘突出症患者,分为三组：A组20例,单纯行髓核成形术;B组30例,髓核成形术后行选择性神经根阻滞治疗;C组20例,单纯行选择性神经根阻滞治疗.治疗前1天,治疗后3天,3个月,6个月测定疼痛视觉模拟评分（VAS）,直腿抬高试验（SLRT）,治疗优良率来评估治疗效果.结果：三组患者治疗后3天VAS值、SLRT值均较治疗前一天明显降低（P＜0.01或P＜0.05）;A组与B组治疗后3个月,6个月VAS值、SLRT值均较治疗前明显降低（P＜0.01或P＜0.05）,C组无明显变化;B组治疗后3个月、6个月VAS值、SLRT值较A组与C组明显提高（P＜0.05）.A组治疗后3天、3个月、6个月时治疗优良率分别为85.0%、80.0%、60%,B组分别为100%、90%、83.3%,C组分别为100%、35%、30%.B组3个月,6个月优良率较A组与C组提高.结论：等离子髓核成形术联合选择性神经根阻滞治疗腰椎间盘突出症,近期优良率100%,提高远期优良率.

Abstract:

Objective:To explore the clinical effect of nucleoplasty combined with selective nerve root block on lumbar disc herniation. Methods: Seventy patients with lumbar disc herniation were divided into three groups: Twenty patients in goup A were treated with nucleoplasty;thirty patients in group B were treated with nucleoplasty combined with selective nerve root block; twenty patients in goup C were treated with selective nerve root block.The theraptic effect was evaluated by comparing the value of VAS, SLRT and excellent and good rate of therapy at 1 day before treatment and at 3 days, 3 months and 6 months after treatment. Results: The value of VAS and SLRT in three groups at 3 days after treatment were remarkably lower than that at 1day before treatment (P<0.05 or P<0.01); The value of VAS and SLRT in group A and group B at 3 months and 6 months after treatment decreased significantly than before treatment (P<0.05 or P<0.01),it is no chang in group C.Compared with those in the group A and group C, VAS scores and SLRT in group B were significantly decreased at 3 monthes and 6 monthes after treatment (P<0.05). The excellent and good rate of therapy at 3 days, 3 and 6 months was respectively 85.0%, 80.0% and 60% in group A, 100%, 90% and 83.3% in group B, 100%, 35% and 30% in group C. There were no serious side effects in all groups. Conclusion: The excellent and good rate of therapy of nucleoplasty combined with selective nerve root block in treating patients with lumbar disc herniation at 3 days after treatment was 100%, and improved the excellent and good rate of therapy at 3 months and 6 months after treatment.