低温等离子射频消融髓核成形术治疗腰椎间盘突出症的临床效果

目的观察腰椎间盘突出症采用低温等离子射频消融髓核成形术治疗的临床疗效。方法选取2012年4～12月北京中医药大学东直门医院东区骨伤科就诊的腰椎间盘突出症患者65例。分为治疗组33例及对照组32例。对照组采用牵引推拿，针灸配合中频、超声波物理和药物治疗，治疗组在此基础上采用低温等离子射频消融髓核成形术治疗。对两组患者的住院时间、患者满意、临床疗效，及视觉疼痛评分（VAS），腰椎功能障碍指数（ODI）评分、症状体征积分、椎间隙高度R值进行比较。结果治疗组患者住院时间（6．83±1．52）d]少于对照组（14．98±2．13）d1，治疗组患者满意率（92．98％）、优良率（93．94％）均高于对照组（72．41％、81．25％），差异均有统计学意义（P〈0．05）。治疗组治疗后VAS、ODI评分分别为（3．57±0．41）分、（10．61±2．37）分，均低于治疗前及对照组治疗后VAS、ODI评分，差异均有统计学意义（P〈0．05）。治疗组随访6、9个月症状体征积分分别为（1．50±30）分、（1．42±0．22）分，均低于对照组（2．61±0．41）、（3．11±0．43）分]，差异有统计学意义（P〈0．05）。两组治疗前、治疗后2周、6、9个月随访时椎间隙高度R值比较，差异均无统计学意义（P〉0．05）。结论低温等离子射频消融髓核成形术治疗腰椎间盘突出症具有创伤小、简单安全、恢复快、手术时间短、脊柱稳定性好等优点。

Clinical curative effect of low temperature plasma radiofrequency nucleo- plasty in the treatment of lumbar intervetebral disc herniation

Objective To observe the clinical curative effect of low temperature plasma radiofrequency nucleoplasty in the treatment of lumbar intervetebral diseherniation. Methods 65 cases of lumbar intervetebral disc herniation from April to December 2012 in Department of Orthopaedics in East District of Dongzhimen Hospital of Beijing University of Chinese Medicine were collected and randomly divided into the treatment group of 33 cases and the control group of 32 cases. The control group was treated by traction and massage, acupuncture combined with intermediate frequency, ultrasonic physical and drug treatment, while the treatment group was treated by low temperature plasma radiofrequency nucleoplasty treatment on the basis of the control group. The hospitalization time, satisfaction, clinical curative effect, VAS, ODI score, symptoms and signs score, R value of height of intervertebral space of patients in the two groups were compared. Results The hospitalization time of patients in the treatment group （6.83±1.52） dI was significantly less than that in the control group （14.98±2.13） d] and the satisfaction rate （92.98%） and excellent and good rate （93.94%） in the treatment group were higher than those in the control group （72.41%, 81.25%）, the differences were statistically significant （P 〈 0.05）. The VAS and ODI score of the treatment group after treatment were （3.57±0.41） scores, （10.61± 2.37） scores respectively, which were lower than those before treatment and the control group after treatment, the differences were statistically significant （P 〈 0.05）. The symptoms and signs score at 6, 9 months of follow-up in the treatment group were （1.50±0.30） scores, （1.42±0.22） scores respectively, which were lower than those in the control group （2.61±0.41）, （3.11±0.43） scores], the differences were statistically significant （P 〈 0.05）. The differences of the R value of height of intervertebral space before treatment, at 2 weeks, 6, 9 months after treatment between the two groups were not statistically significant （P 〉 0.05）. Conclusion Low temperature plasma radiofrequency nucleoptasty in the treat- ment of lumbar intervetebral disc herniation has the advantages of small trauma, simple and safe, quick recovery, short operation time, good spinal stability.