胶原酶溶解术不同方法治疗腰椎间盘突出症效果评价

目的 评估X线"C"型臂引导下盘外注射和CT引导下盘内外联合注射胶原酶治疗腰椎间盘突出症的中远期疗效差异. 方法 将我院腰椎间盘突出症201例随机分为A、B两组,A组106例,B组95例,分别于X线"C"型臂引导下采用盘外注射法(A组)和CT引导下采用盘内外联合注射法(B组)注入胶原酶. 结果 两组穿刺成功率均为100...

Effect of Different Strategies of Collagenase Injection in the Treatment of Lubar Intervertebral Disc Protrusion

Objective To evaluate and compare the effect of CT guided collagenase injection into both inside and outside of intervertebral disc and C-arm guided collagenase injection into outside of disc in treating lumbar disc herniation.Methods 201 patients confirmed as lumbar disc herniation were randomly divided into two groups;group A（n=106） and group B（n=95）.Patients in group A underwent external disc injection of collagenase under the guidance of the C-arm,while patients in group B had CT-guided injection into both inside and outside of the disc.Results The puncture rate was 100% in both the groups.Group A had a success rate of 79.3% at the first punch,while it was 95.8% in group B（P0.01）.Both groups were followed up for 3 years after treatment,with 99 patients in group A,and 90 in group B,with an excellent rate of 79.8 % and 92.2%,respectively.There was significant difference（P0.05）.The occurrence rate of backache was 82.1% in group B,higher than that in group A（23.6%） and the difference was significant（P0.01）.One patient from group A who suffered from severe headaches was treated accordingly,but symptoms disappeared in the other patients with headaches or backaches.Conclusion Both external disc injection of collagenase and combined external and internal disc injection are safe and effective in the treatment of lumbar disc herniation.However,CT-guided combined injection both inside and outside of disc has better effects than C-arm guided injection of just outside of disk.