C型臂引导下硬膜外侧间隙置管神经根松解治疗腰椎间盘突出症的疗效

目的评价C型臂引导下硬膜外侧间隙置管神经根冲击松解治疗腰椎间盘突出症的效果。方法腰椎间盘突出症100例，其中97例完成此研究，在C型臂定位引导下经棘突旁开2～3cm垂直进针，沿小关节内侧缘入路达硬膜外侧间隙侧隐窝注入2％利多卡因5ml和0．9％氯化钠15m1混合液，置入硬膜外导管后，注入含曲安奈德40mg、甲钻胺0．5mg、维生素B_6 200mg、香丹注射液10ml的消炎镇痛液。每隔7d治疗1次，3次为1疗程。治疗效果采用改良VAS评分及MacNab法评价。结果治疗后各时点VAS评分较术前均降低（P〈O．05）；治疗后3个月时，优效为66例（68．1％），良效10例（10．3％），可效11例（11．3％），无效10例（10．3％）。未见严重并发症。结论硬膜外侧间隙置管神经根冲击松解治疗腰椎间盘突出症安全，效果确切。

Efficacy of nerve root release by epidural lateral interspace intubation under C-arm-guidance for the treatment of patients with lumbar intervertebral disc herniation

Objective To evaluate the efficacy of nerve root stoss and release therapy by epi- dural lateral interspace intubation under C-arm-guidance for the treatment of patients with lumbar intervertebral disc herniation. Methods One hundred patients （97 cases completed the research） with lumbar intervertebral disc herniation were punctured vertically at 2～3 cm from spinous process under C-arm-guidance, then 2% lidocaine 5 ml were injected at the lateral recess, epidural catheter was placed along the inside edge of the facet joints. Then the anti-inflammation analgesic mixture was injected, which contained triamcinolone acetonide 40 mg, mecobalamine 0.5 mg, vitamin B6 200 mg and xiangdan （香丹） injection 10 ml. Every 7 days for 1 time, 3 times for 1 course. The thera- peutic efficacy was observed with VAS and modified MacNab method. Results Compared with pre- treatment, VAS was significantly decreased after the treatment （P〈0.05）. There were 66 cases （68.1%）with excellent effect, 10 cases （10.3%） with good effect, 11 cases （11.3%） with poor effect, 10 cases （10.3%） with ineffective effect at third months after the treatment. No severe com- plications were found. Conclusion Nerve root stoss and release therapy by epidural lateral interspace intubation under C-arm-guidance is a safe and effective method for the treatment of patients with lumbar intervertebral disc herniation.