CT导引联合注射胶原酶治疗腰椎间盘突出症的技术与临床应用研究

目的 探讨CT导引下联合注射胶原酶于腰椎间盘突出物表面和突出物内治疗腰椎间盘突出症的技术和疗效。方法 对155例经CT检查证实、临床诊断为腰椎间盘突出症的患者在CT导引下分别于椎间盘突出物表面和突出物内注射胶原酶。L3－4、L4－5采用经椎间孔进针法，L5－S1多采用经小关节内缘、穿黄韧带、达硬膜外进针法。结果 穿刺成功率为100％，经术后3个月至3年的随访，146例疗效优良，优良率为94．2％。随访期间34例进行CT复查，其中32例可见原腰椎间盘突出物变小或消失，疗效均为优、良。2例无变化，疗效为差。2例并发椎间盘炎，经抗炎治疗治愈。结论 CT导引联合注射胶原酶是治疗腰椎间盘突出症安全、有效的方法。

Technical and clinical study on CT-guided collagenase injection in the treatment of herniated lumbar disc

Objective To investigate the technique and effectiveness of CT-guided collagenase injection into prominence of herniated lumbar disc and the surface of prominence in the treatment of lumbar disc herniation. Methods One hundred and fifty-five patients with lumbar disc herniation diagnosed by clinic and CT received CT-guided collagenase injection, with the approaches via intervertebral foramen in L3-4 and L4-5, and the approaches via margo medialis of joint processus articularis in L5-S1. Results Injection was done successfully in all patients (100%), the clinical rate of excellent and good results were 94.2%. The herniation disappeared or significantly reduced as demonstrated by CT scan in 32 of 34 patients (94.1%), the rate of excellent and good results were 100%. No changes existed in 2 cases. There were 2 cases of disc inflammation in our group. Conclusions CT-guided collagenase injection into the prominence of herniated lumbar disc and its surface is a safe and efficient method in the treatment of herniated lumbar disc.