经皮穿刺臭氧髓核消融术治疗腰椎间盘突出症

目的探讨经皮穿刺腰椎间盘髓核臭氧消融术的手术方法、临床疗效及手术适应证。方法选择300例腰椎间盘突出症患者,采用经皮穿刺髓核臭氧消融术治疗,根据髓核突出程度分类,分为A组：膨出型91例;B组：突出型127例;C组：脱出型82例,分别采用安全三角区入路、安全三角区入路＋选择性神经根阻滞和小关节内侧缘入路,行经皮穿刺腰椎间盘髓核臭氧消融术,经6～18个月随访,采用Macnab疗效评定标准,评价其临床疗效。结果 A组有效率82.6%,B组有效率85.7%,C组有效率80.4%,明显高于文献报道,三组间差异无统计学意义（P〉0.05）。结论不同类型腰椎间盘突出症采用不同入路方法的经皮穿刺髓核臭氧消融术,其治疗效果对比无显著性差异,应根据患者腰椎间盘突出症类型选择适合的手术入路方法。

Clinical Research of Ozone Discectomy Via Percutaneous Catheter Ablation of Lumbar Disc Herniation with Different Approachs

Objective To investigate operation methods,clinical efficacy and indication of the ozone nucleus ablation of lumbar disc herniation.Methods 300 cases with lumbar disc herniation were divided into three groups,group disc degeneration,group prolapse and group extrution,treated respectively by different approachs of ozone discectomy via percutaneous catheter ablation.All patients were followed up range 6 to 18 months.According to MacNab criteria.Results The rate of good and excellent results was respectively 82.6%,85.7% and 80.4%,higher than articles reported,There was no significant difference among the three groups（P〉0.05）.Conclusion Patients with lumbar disc herniation of different types should be treated with different approachs of ozone discectomy via percutaneous catheter ablation.