2012-1-21CT引导下射频消融联合臭氧治疗治疗极外侧型腰椎间盘突出症.docVIP

临床论著 射频消融联合臭氧治疗外侧型腰椎间盘突出症 陈振中 陈小勇 姜成龙 吴海波海南省三亚市中医院骨伤科572000 摘要：目的：评价射频消融联合臭氧治疗极外侧型腰椎间盘突出症的临床疗效。方法： 92例患者，随机分为2组。治疗组53例，对照组39例，治疗组用射频消融联合臭氧治疗，对照组注射臭氧治疗。结果：于术后3个月进行随访检查，治疗组优良率为84.9%，对照组总有效率为61.5%，2组优良率比较，差异有意义(P0.05)。结论：射频消融联合臭氧较单独运用射频消融治疗腰椎间盘突出症效果更好。 关键词：极外侧型腰椎间盘突出症；射频消融联合臭氧；CT引导 CT guided injection of radiofrequency ablation and ozone in treatment of far lateral lumbar intervertebral disc herniation Chenzhenzhong Chenxiaoyong Jiangchenglong Xiongshixi Department of Surgery，Sanya University hospital Hainan，Sanya 572000，China Abstract: Objective:To study the clinical therapeutic effect of CT—guided injection of radiofrequency ablation and ozone in the treatment of far lateral lumbar intervertebml disc herniation．Methods: All 92 patients with far lateral lumbar intervertebml disc herniation were randomly divide into 2 groups. 53 patients in treat group with the treatment of CT梘uided injection of radiofrequency ablation and ozone ,others in control group with the treatment of CT梘uided injection of Mozone.Results: The therapeutic effect during 3 months after operation were observed. The fineness rate in treat group is 84.9%, while 61.5% in control group.The difference do sense．Conclusions:Operation under CT—guidance is safe and accurate．The injection of o radiofrequency ablation and ozone in far lateral lumbar intervertebral disc herniation is a minimally invasive and effective method． Key words: Far lateral lumbar intervertebral disc herniation； radiofrequency ablation and ozone therapy；CT—guided injection 极外侧椎间盘突出症为腰椎间盘突出症中的一种特殊类型[1]，临床上并不少见，其发生率占整个腰椎间盘突出症的2.6％-11.7％[2], 以往对其认识不充分, 近年来的报道也多集中于手术术式方面, 由于解剖结构的关系,手术操作对组织结构的损伤和破坏较大, 易造成腰椎稳定性差, 并发症多。近些年来，微刨介入治疗得到了迅速发展，其中臭氧融盘术被证明是有效的方法之一。但极外侧型突出因小关节阻挡药物难以送达，影响疗效。作者在CT引导下经小关节内外侧入路射频消融联合臭氧治疗92例，效果显著，报道如下。 1 一般资料 1.1 诊断标准 参考《腰椎间盘突出症》[1]的相关标准：腿痛重于腰痛，腿痛呈典型的坐骨神经分布区域，按神经分布区域的麻木，直腿抬高试验阳性，或较正常减少50％，作弓弦试验引起肢体的远近两端的放射痛，CT或MRI检查亦发现相关的极外侧型椎间盘病变。 1.2 纳入标准 ① 临床标准：有腰痛伴膝以下放射痛，年龄20-59岁，病程≤3年，直腿抬高试验70°。伴或不伴相应支配区麻木或感觉减退，趾背伸肌力、跖屈肌