背根神经节脉冲射频联合腰椎侧隐窝阻滞治疗腰椎管狭窄症

目的 探讨背根神经节脉冲射频联合腰椎侧隐窝阻滞治疗腰椎管狭窄症的临床疗效及安全性。 方法 选取2014年6月至2017年6月采用背根神经节脉冲射频联合侧隐窝阻滞治疗的腰椎管狭窄症患者40例(观察组),并抽取同期采用单纯侧隐窝阻滞治疗的腰椎管狭窄症患者40例(对照组)。比较两组治疗前及治疗后1周,1、3、6个月的疼痛视觉模拟(VAS)评分及改良MacNab标准评估结果,对可能影响疗效的因素行Logistic回归分析,并记录不良反应。 结果 术前两组年龄(P=0.646)、性别(P=0.823)、VAS评分(P=0.945)比较差异无统计学意义;与治疗前相比,两组治疗后各阶段VAS评分均减低,差异有统计学意义(P<0.001);与对照组相比,观察组在治疗后3个月(P=0.011)、6个月(P=0.040)VAS评分明显降低;观察组术后1个月(P=0.014)、6个月(P=0.013)的优良率明显高于对照组;Logistic回归分析提示,观察组疗效优于对照组;观察组无明显并发症,对照组2例感染脊柱间盘炎。 结论 背根神经节脉冲射频联合腰椎侧隐窝阻滞治疗腰椎管狭窄症临床疗效优于单纯腰椎侧隐窝阻滞治疗。

Dorsal root ganglion pulsed radiofrequency combined with lumbar lateral recess block in the treatment of lumbar spinal stenosis

Objective To investigate the clinical efficacy and safety of dorsal root ganglion(DRG)pulsed radiofrequency(PRF)combined with lumbar lateral recess block in treatment of lumbar spinal stenosis(LSS). Methods A total of 40 patients with LSS treated with DRG-PRF combined with lateral recess block during June 2014 and June 2017 were enrolled as the observation group, and 40 patients with LSS treated with simple lateral recess block served as the control group. The visual analogue scale(VAS)was observed before treatment, 1 week, 1 month, 3 months and 6 months after treatment. The results were graded as excellent, good, fair or poor based on modified MacNab criteria. The possible risk factors affecting the curative effect were analyzed with Logistic regression. The complications and adverse reactions were recorded. Results There were no significant differences between the two groups in age(P=0.646), gender(P=0.823)and VAS scores before treatment(P=0.945). VAS scores decreased significantly after treatment in both groups(P<0.001), but the observation group had a more remarkable decrease 3 months(P=0.011)and 6 months(P=0.040)after trealment. The observation group had higher excellent and good rates 1 month(P=0.014)and 6 months(P=0.013)after treatment than the control group. Logistic regression analysis indicated that the curative effect was better in the observation group. No serious complications were observed in the observation group, while spondylodiscitis occurred in 2 cases in the control group. Conclusion The combination of DRG-PRF and lumbar lateral recess block shows better efficacy than simple lumbar lateral recess block in the treatment of LSS.