超声引导下射频损毁腰脊神经后内侧支对腰椎小关节综合征的治疗效果及安全性分析

目的探讨超声引导下射频损毁腰脊神经后内侧支对腰椎小关节综合征的治疗效果和安全性。方法选取2016年3月~2017年4月我院收治的80例腰椎小关节综合征患者为研究对象,随机分为对照组和观察组,每组40例。观察组给予超声引导下射频损毁腰脊神经后内侧支进行治疗,对照组给予消炎镇痛药进行治疗,采用视觉模拟评分(VAS)评价患者腰痛程度,比较两组患者入院时、出院时及治疗结束后半年的VAS评分,根据VAS评分来评价临床疗效;同时比较两组患者治疗过程中和治疗结束后半年的副作用。结果入院时,两组患者VAS评分无显著差异;出院时和治疗结束后半年两组患者VAS评分均降低,且观察组降低程度显著高于对照组,差异有统计学意义(P0.05);治疗结束半年后,观察组临床有效率为90.0%,显著高于对照组的52.5%,差异有统计学意义(P0.05);两组患者治疗过程中和治疗结束后半年均未出现背部皮肤感觉功能缺失和神经根损伤等副反应。结论在超声引导下行射频损毁腰脊神经后内侧支治疗腰椎小关节综合征,其临床疗效显著,疗效持久,安全性高,值得临床推广应用。

Therapeutic effect and safety analysis of ultrasound-guided radiofrequency ablation of lumbar nerve posterior medial branch in the treatment of lumbar facet joint syndrome

Objective To investigate the therapeutic effect and safety of ultrasound-guided radiofrequency ablation of lumbar nerve posterior medial branch in the treatment of lumbar facet joint syndrome. Methods A total of 80 patients with lumbar facet joint syndrome who were admitted to our hospital from March 2016 to April 2017 were selected as the study subjects. The patients were randomly divided into control group and observation group, with 40 patients in each group. The observation group was given ultrasound-guided radiofrequency ablation of lumbar nerve posterior medial branch for treatment, and the control group was given anti-inflammatory drugs and analgesics for treatment. The visual analog scale(VAS) was used to evaluate the patients'' degree of pain, and the VAS scores upon admission, upon discharge and six months after the end of treatment were compared between the two groups. According to the VAS scores, the clinical efficacy was evaluated; at the same time, the adverse reactions were compared between the two groups during the course of treatment and 6 months after the end of treatment. Results Upon admission, there was no significant difference in VAS scores between the two groups; VAS scores were lower in both groups at discharge and six months after the end of treatment, and the reduction in the observation group was significantly higher than that in the control group. The differences were statistically significant(P<0.05); six months after the end of treatment, the clinical efficacy in the observation group was 90.0%, significantly higher than that in the control group(52.5%), and the difference was statistically significant(P<0.05); skin sensory loss in the back and nerve root injury and other side effects were not observed during treatment and 6 months after the treatment in both groups. Conclusion Ultrasound-guided radiofrequency ablation of lumbar nerve posterior medial branch in the treatment of lumbar facet joint syndrome has significant clinical efficacy, durable efficacy, and high safety, which is worthy of clinical promotion and application.