胶原酶注入腰椎间盘突出物内及硬膜外腔溶解术疗效评价

目的：探讨腰椎间盘突出物（髓核）内及硬膜外腔注入胶原酶溶解术的疗效.材料和方法：在CT导引下经椎板间孔穿刺注入胶原酶治疗163例腰椎间盘突出症患者,其中62例实施硬膜外腔内注药,另一组101例实施突出物内注药.根据日本骨科学会制定的腰腿痛疗效判断标准[1],对两组病例术后疗效进行随访比较.结果：突出物（髓核）内注药法：优41例,占40.59%;良51例,占50.5%;可6例,占5.94%;差3例,占2.97%.硬膜外腔注药法：优14例,占22.58%;良28例,占45.16%;可13例,占20.97%;差7例,占11.29%.两组疗效进行χ2检验（χ^20.005（3）=15.69,P＜0.005）有显著差异.结论：突出物（髓核）内注药疗效明显,其效果优于硬膜外腔内注药.

The Therapeutic Effect of Transdermal Collagenase Injection into Protrusion or Epidural Space for Lumbar Disc Herniation

Objective:To compare the therapeutic effect of transdermal collagenase injection into the protrusion or epidural cavity for lumbar disc herniation.Method:Total 163 cases of lumbar disc herniations were randomly divided into two groups:the first group,injection of collagenase into the epidural cavity was carried out in 62 cases under the guidance of CT;and the second group of 101 cases into the protrusions.The curative effects were compared during the 9 months follow-up after operation,according to the standard by the thopaedic Association of Japan.Results:In the first group,there were 14 cases having excellent outcomes(2258%);28cases with good outcomes(4516%);13 cases with moderate improvement(2097%);and 7 cases with poor outcomes(1129%).Compared with it,the pecond group,41 cases had excellent outcomes(4059%);51 cases with good ouecomes(505%);6 cases with moderate improvement(594%);and 4 cases with poor outcomes(297%).Chi-Square test shows that there was significant difference of the curative effects between the two groups(P<0005).Conclusions:The curative effect of injection into protrusions was much better than that into the epidural cavity.