骶管注射疗效与腰椎间盘突出症不同节段、类型、病程的关系

目的:观察骶管注射对不同节段、类型、病程腰椎间盘突出症的治疗疗效,为临床适应证的选择提供依据。方法:对2007年3月至2011年5月采用骶管注射治疗的329例腰椎间盘突出症患者进行回顾性分析,其中男178例,女151例;年龄16～78岁,平均45岁;病程2d～41年,平均4.1年。突出节段:L3,451例,L4,5142例;L5S1136例,均为单节段突出。中央型137例,侧方型145例,极外侧型47例。329例患者按不同的突出节段、类型、病程(大于6个月和小于6个月)进行分组,分类比较各组疗效。结果:L5S1突出组的疗效优于L3,4、L4,5突出组。病程小于6个月组疗效优于病程大于6个月组。侧旁型疗效优于中央型、极外侧型。同时满足3个条件组(病程小于6个月、L5S1突出、侧旁型突出)疗效优于不满足组。所有患者均无并发症,治愈患者均经电话及门诊随访1年,复发率为0.05%。结论:病程较短、下段及侧旁型突出的疗效较好,更适合用骶管注射治疗;同时满足病程小于6个月、L5S1突出、侧旁型突出的采用骶管注射疗效最好。

Relationship between effect of sacral canal injection and different sections,types,courses of lumbar intervertebral disc herniation

Objective: To observe the effects of sacral canal injection in treating lumbar intervertebral disc herniation with different sections,types and courses,in order to provide selective basis for clinical indications.Methods: From March 2007 to May 2011,329 patients with lumbar intervertebral disc herniation were treated with sacral canal injection and their data were retrospectively analyzed. There were 178 males and 151 females,ranging in age from 16 to 78 years old with an average of 45 years;ranging in course of disease from 2 days to 41 years with an average of 4.1 years. All the protrusions were simple segment,and L_3,4 of 51 cases,L_4,5 of 142 cases,L₅S₁ of 136 cases including central protrusion of 137 cases,posterolateral of 145 cases,extreme posterolateral of 47 cases. According to different sections,types,courses(more than or less than 6 months) of lumbar intervertebral disc herniation,the patients were divided into several groups,clinical effects of the groups were compared and analyzed.Results: Clinical effect of protrusion in L₅S₁ group was better than that of L_3,4,L_4,5 group; the effect of patients with course less than 6 months was better than with course more than 6 months;effect of posterolateral protrution was better than that of central and extreme posterolateral protrusion. Clinical effect of corresponding the three conditions was better than that of others no corresponding the three conditions,the three conditions included the course less than 6 months,protrusion in L₅S₁ section,with type of posterolateral protrusion. No complications were found in all patients and cured patients were followed up for 1 year with the recurrence rate of 0.05%.Conclusion: The patients with short course,lower protrusion,type of posterolateral protrusion can obtained better effects,while the patients who meets the three conditions is appropriate mostly to sacral canal injection therapy.