CT导向下经皮臭氧注射腰椎间盘溶解术的临床研究

目的：研究CT引导下臭氧注射腰椎间盘溶解术治疗腰椎间盘突出症的价值。方法：136例腰椎间盘突出症患者,经CT或MRI证实,保守治疗3月以上无效。手术在严格的无菌条件下进行。局麻,CT导向下用18 G穿刺针穿刺病变椎间盘并注射浓度为50μg/ml的臭氧气体20 ml,必要时在退针至椎间孔附近时,向椎旁组织内注入臭氧10 ml。依据Mac-Nab腰腿痛手术评价标准评价治疗效果。分析患者年龄、病程、突出程度、是否累及多个椎间盘等相关因素对疗效的影响。结果：136例患者随访3～24月,显效56例（41.2%）,有效69例（50.7%）,无效11例（8%）,总有效率近92%。术后无1例并发症。结论：CT引导下经皮臭氧注射腰椎间盘溶解术是治疗腰椎间盘突出症的一种安全有效的微创方法。

Clinnical study of percutaneous treating lumbar disc herniation by CT-guided with O3 injection

Objective:To study the value of treating the lumbar disc herniation with O3 injection under CT guided.Metheds:One hundred and thirty-six cases of patients with lumbar disc herniation,which were confirmed by CT or/and MR,were included in this study.They all complained sciatica and/or low back pain,and no benefits were obtained from the treatment of conservation means for at least three months.Complete asepsis was kept during the procedure of percutaneous intradiscal O3 injection.Discs were injected 20ml of O3 with 18g needles under local anesthsia and CT guidance,and 10ml of O3 were also injected into the paravertebral space as the needle was withdrawn near the interverbral foramen.The O3 concentration was 50 μg/ml.The evaluation of curative effect was performed according to MacNab criteria.Results:All pitiants were followed up over the period of 3~24 months.The overall efficiency was about 92%(125 cases) with the excllent 41.2%(56 cases),the good 50.7%(69 cases) and the poor 8%(11 cases).No complications were found throughout this study and all patients were fowllowed up after the treatment.Conclsion:CT-guided percutanous microwounded lumbar disc herniation with O3 injection is a safe and effective method.