经皮穿刺盘内注射臭氧+神经根封闭治疗腰椎间盘突出症.docVIP

经皮穿刺盘内注射臭氧+神经根封闭治疗腰椎间盘突出症[摘要] 目的:探讨经皮穿刺盘内注射臭氧(O3)+神经根封闭治疗腰椎间盘突出症的效果。方法:对25例32个椎间盘,在C形臂X线机透视下穿刺达病变的椎间盘,注射3～5 ml臭氧,退针后在神经根附近注入5～10 ml臭氧,再注入利多卡因、曲安奈德、维生素B12混合物3～5 ml。结果:对患者进行随访,疗效分为优、良、差,优良率达85%。结论:臭氧盘内注射+神经根封闭是治疗腰椎间盘突出症的一种有效、安全的微创方法。 [关键词] 腰椎间盘;髓核;臭氧 [中图分类号] R681.5 [文献标识码]B[文章编号]1673-7210(2010)02(b)-156-02 Treatment of lubar intervertebral disc protrusion with percutaneous puncture intra-disc injecting O3 combined with nerve root block QIAN Chengxiong, LI Hongchao, XU Lihang, XU Jinsen, PENG Xuewen (Department of Surgery, Wanjiang Hospital of Dongguan City, Guangdong Province, Dongguan 523050, China) [Abstract] Objective: To evaluate the therapeutic effect of percutaneous puncture intra-disc injecting O3 combined with nerve root block in the treatment of lubar intervertebral disc protrusion. Methods: 25 patients with lubar intervertebral disc herniation were selected in this study. The puncture was guided by C-arm X-ray. 3-5 ml ozone was injected into 25 herniated disc spaces. After needle withdrawal, 5-10 ml ozone and 3-5 ml mixture of Lidocaine, Triamcinolone Acetonide and vitamin B12 was injected to the area near nerve root. Results: By following up patients, efficacy was evaluated by excellent, good and bad. The excellent and good rate was 85%. Conclusion: The therapeutic method developed by using percutaneous puncture intra-disc injecting O3 combined with nerve root block is a safe and effective method for the treatment of lubar intervertebral disc herniation. [Key words] Lumbar disc; Nucleus pulposus; Ozone 笔者将我院和广州南方医院2008年1~12月收治的25例腰椎间盘突出症的体会报道如下: 1 资料与方法 1.1一般资料 选择我院和广州南方医院2008年1月～2008年12月收治的腰椎间盘突出症25例32个椎间盘,男19例,女6例;年龄28～62岁,平均41.6岁;病史0.5～5年,所有病例均有腰痛,伴有一侧或双侧下肢放射痛,直腿抬高试验阳性,加强试验阳性,全部病例均行MRI证实腰椎间盘突出,腰4、5椎间盘突出7例,腰5骶1椎间盘突出10例,腰4、5及腰5骶1椎间突出8例。 1.2 手术方法 根据MRI片,确定椎间盘突出的位置:穿刺点以髂嵴最高点作一直线与棘突连线垂直,相交点外6～11 cm处进针,进针角度躯干矢状面夹角35°～45°,经“安全三角”进入病变椎间盘,穿刺针尖位于椎间盘的中心或中后1/3交界处,所用穿刺针口径18～23 G,利用医用纯氧经臭氧发生器,产生臭氧浓度30～40 μg/L,经穿刺针缓慢注入椎间盘后,穿刺针退至椎间