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应用臭氧椎间盘注射治疗腰椎间盘突出症162例临床探讨
引用本文:吴清华,姜建威,吴震海,李新胜,成 岗.应用臭氧椎间盘注射治疗腰椎间盘突出症162例临床探讨[J].南京医科大学学报,2008,28(4):550-553.
作者姓名:吴清华  姜建威  吴震海  李新胜  成 岗
作者单位:无锡市第三人民医院介入科,江苏无锡214041
摘    要:目的:探讨应用医用臭氧治疗腰椎间盘突出症的临床疗效及适应证范围.方法:腰椎间盘突出症162例,按照CT/MRI表现将椎间盘突出分为3种,比较不同类型椎间盘突出的治疗结果;均经皮腰椎间盘内注射浓度为40μg/ml医用臭氧6-15 ml,退针至椎间孔附近时,向椎旁组织内神经根旁注入臭氧10 ml及复方倍它米松1 ml 2%利多卡因0.5 ml 维生素B12注射液0.5 mg的混合液;按照纤维环是否破裂分组研究纤维环破裂与疗效的关系;另对3例椎间盘突出伴骨性椎管狭窄导致腰腿痛患者行试验性的臭氧注射治疗.结果:162例腰椎间盘突出症患者行臭氧注射治疗后6个月复查141例有效,总有效率为87.03%,其中34例椎间盘膨出31例有效(91.18%),119例椎间盘突出106例有效(89.08%),9例椎问盘脱垂4例有效(44.44%);72例纤维环完整者63例(87.5%)有效,47例纤维环破裂者32(68.05%)例有效;统计学差异均有显著性.3例椎间盘突出伴骨性椎管狭窄6个月后随访发现2例有效.均无任何并发症.结论:运用臭氧治疗腰椎间盘突出症方法疗效确切,膨出突出类型疗效较高;纤维环破裂疗效较好,对轻度的椎间盘突出伴骨性椎管狭窄可以试行臭氧消融治疗.

关 键 词:臭氧  腰椎间盘突出症
文章编号:1007-4368(2008)04-0550-04
收稿时间:2007/8/22 0:00:00
修稿时间:2007年8月22日

Oxygen-ozone injection for the treatment of lumbar disc herniation:clinical therapeutic effect analysis with 162 cases
WU Qing-hu,JIANG Jian-wei,WU Zhen-hai,LI Xin-sheng and CHENG Gang.Oxygen-ozone injection for the treatment of lumbar disc herniation:clinical therapeutic effect analysis with 162 cases[J].Acta Universitatis Medicinalis Nanjing,2008,28(4):550-553.
Authors:WU Qing-hu  JIANG Jian-wei  WU Zhen-hai  LI Xin-sheng and CHENG Gang
Abstract:Objective:To evaluate the therapeutic effect and indication for the treatment of lumbar disc herniation using intradiscal and paraspinal injection with O2-O3 mixture. Methods:One hundred and sixty-two patients were selected and divided into three groups by their category of the lumbar disc herniation which were verified by CT or MR imaging. For each herniated disc treatment,6~15 ml O2-O3 mixture at 40 ug/ml was injected into intradiscal space, and 10 ml of O2-O3 mixture were also injected into the paravertebral space when the needle withdrawned near the nerve root of the intervertebral forame,then the mixture of compound betamethason(1 ml), lidocaine(0.5 ml) and vitaminB12(0.5 mg) was injected. They were also divided into two groups with or without fibrous annulus,the correlation between fibrous annulus broken and therapeutic effect was studied. In addition,three patients with lumbar disc protrusion accompanied spinal stenosis were performed tentative ozone injection. Results:The patients were followed up from 6 months after treatment. The overall efficacy was 76.6%(141/162). Among them,31 cases(91.17%)in 34 bulging patients and 106 cases(89.07%) in 119 patients protrusion had excellent recovery;4 cases(44.44%)in 9 extrusion patients had significant relief of symptoms;63 cases(87.5%)in 72 patients with intact fibrous annulus and 32 cases(68.05%) in 47 patients with broken fibrous annulus had excellent recovery;There was significant difference in therapeutic effect existed between bulging,protrusion patients and extrusion patients. The same outcome was found between intact fibrous annulus groups and broken fibrous annulus groups. Two cases in three patients whose lumbar disc protrusion accompanied spinal stenosis had excellent recovery. No serious complication occurred. Conclusion:The therapeutic method developed by injecting O2-O3 mixture in lumbar intradiscal and paraspinal space was a safe and effective method for the treatment of the lumbar disc herniation. The therapeutic effect was fine in bulging, protrusion groups and intact fibrous annulus groups. Ozone ablation therapy might be tried in the patient with lumbar disc protrusion accompanied spinal stenosis.
Keywords:oxygen-ozone  lumbar disc herniation
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