脊髓电刺激治疗腰椎手术失败综合征的疗效分析-中国康复医学杂志.PDF

Chinese Journal of Rehabilitation Medicine, Dec.2012, Vol.27,No.12 ·临床研究· 脊髓电刺激治疗腰椎手术失败综合征的疗效分析 杨立强 倪家骧1 1，2 摘要 目的：探讨脊髓电刺激（SCS）治疗腰椎手术失败综合征（FBSS）的临床疗效评定。 方法：选取FBSS患者31例，随机分为两组：A组进行连续硬膜外腔镇痛联合胶原酶注射或椎间盘射频联合臭氧注射 等传统介入手术治疗组（16例）。B组进行硬膜外腔SCS治疗组（15例）。在治疗前、治疗后1周、1个月、6个月、12个 月，分别采用视觉模拟评分法（VAS）、Oswestry功能障碍指数（ODI）、日本骨科学会（JOA）腰痛评估表进行疗效分析。 结果：两组治疗后1周、1个月、6个月、12个月VAS值均较治疗前明显降低（P0.01），ODI指数均较治疗前明显降低 （P0.01），JOA值均较治疗前明显提高（P0.01）。B组在治疗后12个月的VAS 值、ODI指数、JOA值较A组明显改 善（P0.05）。 结论:脊髓电刺激（SCS）治疗腰椎术后失败综合征（FBSS）疗效优于传统的微创介入手术。 关键词 脊髓电刺激；腰椎手术失败综合征；评定 中图分类号：R454.1 文献标识码：A 文章编号：1001-1242（2012）-12-1106-05 Evaluation of spinal cord stimulation for the treatment of fail back surgery syndrome/YANG Liqiang,NI Jiaxiang//Chinese Journal of Rehabilitation Medicine ，2012 ，27(12): 1106—1110 Abstract Objective: To investigate the efficacy of spinal cord stimulation (SCS) for the treatment of fail back surgery syn- drome(FBSS). Method: Thirty-one patients with FBSS were randomly assigned to A group and B group. A group was given conventional interventional management as continuous epidural infusion combined with collagenase injection, or in- tervertebral disc radiofrequency combined with ozone injection (n=16). B group was given epidural spinal cord stimulation treatment (n=15). Patients were asked to rate their pain with visual analogue scale (VAS) 1 week, 1 month，6 months and 1 year after treatment. Oswestry disability index (ODI), Japanese orthopedic association(JOA) lowbackpainscorewere also collected. Result: The VAS and ODI scores decreased significantly in both groups 1 week, 6 months and 1 year after treat- ment（P ＜0.01). JOA scores improved also in both group at the same time. Compared with A group, patients in B groupreportedsuperiorpain relief, ODIand JOA scoreimprovements. Conclusion: SCSprovidedbet