| 艾 龙,开赛尔·艾里,米尔夏提江·麦麦提艾力,龙 浩,卡米力江·乌斯曼.CT引导下腰椎间盘靶点射频消融与经皮椎间孔镜髓核摘除术对腰椎间盘突出症的效果对比[J].现代生物医学进展英文版,2024,(14):2723-2727. |
| CT引导下腰椎间盘靶点射频消融与经皮椎间孔镜髓核摘除术对腰椎间盘突出症的效果对比 |
| Comparison of the Effects of CT Guided Radiofrequency Ablation of Lumbar Disc Targets and Percutaneous Foraminal Endoscopic Nucleus Pulposus Removal on Lumbar Disc Herniation |
| Received:January 27, 2024 Revised:February 23, 2024 |
| DOI：10.13241/j.cnki.pmb.2024.14.023 |
| 中文关键词: 腰椎间盘 射频消融 经皮椎间孔镜髓核摘除术 腰椎间盘突出症 |
| 英文关键词: Lumbar intervertebral disc Radiofrequency ablation Percutaneous intervertebral foramen endoscopic removal of nucleus pulposus Lumbar disc herniation |
| 基金项目:新疆维吾尔自治区自然科学基金项目（2020D01C197） |
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| 中文摘要: |
| 摘要 目的：对比CT引导下腰椎间盘靶点射频消融与经皮椎间孔镜髓核摘除术对腰椎间盘突出症的效果。方法：选取2020年10月到2021年10月收治的120例腰椎间盘突出症患者进行回顾性分析，依照其手术方式差异进行分组，其中60例患者采取CT引导下腰椎间盘靶点射频消融术治疗将其分为射频消融组，将60例采取经皮椎间孔镜髓核摘除术治疗的患者分为经皮椎间孔镜组。对比两组患者临床治疗效果，手术时间、术中出血量、首次下床时间和住院时间，分别在两组患者手术前、术后1个月、3个月及6个月采用视觉模拟疼痛量表（VAS）、日本骨科协会评估治疗（JOA）、Osweatry功能障碍指数（ODI）评价其近远期疼痛程度、腰椎功能及下肢功能障碍情况，最后对比两组患者术后并发症发生率。结果：射频消融组与经皮椎间孔镜组患者治疗优良率对比无明显差异（P＞0.05）；射频消融组手术时间高于经皮椎间孔镜组，射频消融组术中出血量、首次下床时间和住院时间低于经皮椎间孔镜组（P＜0.05）；手术后1个月、3个月、6个月两组患者JOA评分升高，经皮椎间孔镜组术后6个月JOA评分高于射频消融组，手术后1个月、3个月、6个月两组患者VAS评分、ODI指数均降低，经皮椎间孔镜组术后6个月VAS评分低于射频消融组（P＜0.05）；射频消融组与经皮椎间孔镜组患者神经损伤、腰大肌旁血肿、腰椎不稳、术后感染等并发症发生率对比无明显差异（P＞0.05）。结论：CT引导下腰椎间盘靶点射频消融与经皮椎间孔镜髓核摘除术治疗腰椎间盘突出症的临床疗效及安全性并无显著差异，CT引导下腰椎间盘靶点射频消融手术创伤性小，术中出血量低，可促进患者术后早期康复，而经皮椎间孔镜髓核摘除术可进一步减轻患者术后远期疼痛程度，促进腰椎功能恢复，改善下肢功能障碍情况。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the effects of CT guided radiofrequency ablation of lumbar intervertebral disc targets and percutaneous foraminal endoscopic nucleus pulposectomy on lumbar disc herniation. Methods: A retrospective analysis was conducted on 120 patients with lumbar disc herniation from October 2020 to October 2021. They were divided into groups according to the differences in surgical methods. Among them, 60 patients were treated with CT guided lumbar disc target radiofrequency ablation and were divided into the radiofrequency ablation group. The remaining 60 patients were treated with percutaneous foramen endoscopic nucleus pulposectomy and were divided into the percutaneous foramen endoscopic group. Compare the clinical treatment outcomes of two groups of patients, including surgical time, intraoperative blood loss, first time out of bed, and length of hospital stay. Visual Analog Pain Scale (VAS), Japanese Orthopaedic Association Scores (JOA) were used before surgery, 1 month, 3 months, and 6 months after surgery, respectively The Osweatry Dysfunction Index (ODI) evaluates the degree of pain, lumbar spine function, and lower limb dysfunction in the near and long term, and finally compares the incidence of postoperative complications between the two groups of patients. Results: There was no significant difference in the excellent and good treatment rates between the radiofrequency ablation group and the percutaneous foraminal endoscopy group (P>0.05); The surgical time in the radiofrequency ablation group was higher than that in the percutaneous foraminal mirror group, while the intraoperative blood loss, first time out of bed, and hospital stay in the radiofrequency ablation group were lower than those in the percutaneous foraminal mirror group (P<0.05); After 1 month, 3 months, and 6 months of surgery, the JOA score of the two groups of patients increased. The JOA score of the percutaneous foramen mirror group was higher than that of the radiofrequency ablation group at 6 months after surgery, while the VAS score and ODI index of the two groups decreased at 1 month, 3 months, and 6 months after surgery. The VAS score of the percutaneous foramen mirror group was lower than that of the radiofrequency ablation group at 6 months after surgery (P<0.05); There was no significant difference in the incidence of complications such as nerve injury, parasoas major hematoma, lumbar instability, and postoperative infection between the radiofrequency ablation group and the percutaneous foraminal endoscopy group (P>0.05). Conclusion: CT guided lumbar disc target radiofrequency ablation and percutaneous intervertebral foramen lens nucleus pullla treatment of lumbar disc herniation clinical curative effect and safety and no significant difference, CT guided lumbar disc target radiofrequency ablation trauma, low intraoperative bleeding, can promote early postoperative rehabilitation, and percutaneous interforaminal lens nucleus pullla can further reduce postoperative future pain degree, promote lumbar function recovery, improve lower limb dysfunction. |
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