不同档位的脊神经后支低温等离子射频消融术治疗腰椎小关节疼痛的回顾性研究林鹋2(共同第一作者)苗羽1(共同第一作者) 朱谦1 毛鹏1司马蕾1 樊碧发1△(通讯作者)

Clinical efficacy and safety comparison of low-temperature plasma radiofrequency ablation at different level of the posterior branch of the spinal nerve for the treatment of lumbar facet joint pain

摘要:

通过回顾性分析探讨不同档位的低温等离子射频消融术（?Low-temperature plasma radiofrequency ablation ，LTPRA）治疗腰椎小关节(Lumbar Facet Joint ，LFJ)疼痛的临床疗效及安全性，为临床提供理论依据。方法：纳入2021年2月至 2022年 2月在中日友好医院疼痛科接受手术治疗的 92名LFJ疼痛住院病人，分别对术前、术后第2周、1个月、3个月、6个月、12个月的NRS评分、Oswestry残疾指数(ODI)、NSAIDs和（或）阿片类药物的使用情况、手术相关并发症进行随访评估以及统计学分析。结果：与术前相比，术后2周、1个月、3个月、6个月、12个月的NRS和ODI评分评分均明显下降，均具有统计学意义；药物使用率同样明显下降。组间比较发现，术后1个月至 12月 3档组NRS评分均低于1档组，术后2周以及术后6个月至术后12个月的时段，3档组ODI评分均低于1档组，且差异具有统计学意义。3档组中更多比例患者出现术后短期轻度并发症，但差异无统计学意义。结论：针对LFJ疼痛，1档、3档治疗均有效，3档的治疗效果更优、持续时间更长，术后短期可能出现轻度的并发症，术后并发症与1档相比无统计学差异。

Abstract:

Objective: This retrospective analysis explored the clinical efficacy and safety of low-temperature plasma radiofrequency ablation (LTPRA) of different levels in the treatment of lumbar facet joint (LFJ) pain, providing theoretical bases for clinical practice. Methods: 92 patients with LFJ pain who received surgical treatment at the Pain Depatmrent of China-Japan Friendship Hospital from February 2021 to February 2022 were included. The patients" numerical rating scale (NRS) score, the Oswestry Disability Index (ODI) score, the proportion of nonsteroidal antiinflammatory drugs (NSAIDs) and/or opioid drugs used, surgical related complications and patient satisfaction,before surgery, at the 2nd week,the 1st month,the 3rd month,the 6th month and the 12th month after surgery, were respectively followed up and statistically analyzed. Result: Compared with pre-operation, the NRS score and ODI score decreased significantly at the 2nd week,the 1st month,the 3rd month,the 6th month and the 12th month after surgery,with statistical significance. The postoperative drug use rate also decreased. Comapared with the 1st level group,the NRS score of the 3rd level group was lower from 1 month to 12 months after operation,with statistical significance.The ODI score of the 3rd level group was also lower than the 1st level group,at 2nd week and from 6 months to 12 months after operation,with statistical significance. More patients in the 3rd level group had short-term postoperative mild complications, but the difference was not statistically significant. Conclusion: For LFJ pain, both the 1st and 3rd level LTPRA treatments are effective. Compared with the 1st level LTPRA treatment,3rd level LTPRA treatment has better efficacy with longer duration.While mild complications may occur in the short term after surgery, there is no significant difference in postoperative complications.