经皮穿刺等离子消融髓核成形术在腰腿痛治疗中的应用

目的：探讨应用经皮穿刺等离子消融髓核成形术治疗几种引起腰腿痛常见疾病的临床疗效。方法：对42例经X线平片、MRI以及椎间盘造影等影像学检查，并结合临床表现明确诊断的腰腿痛患者行等离子消融髓核成形术，其中椎间盘源性疼痛25例，椎间盘突出症12例，退行性椎管狭窄症5例（年龄均在65岁以上）。观察患者手术前、后及随访时的症状和体征，分别在手术前、手术后1周及随访时记录患者VAS评分。结果：所有病例的穿刺及消融过程均顺利完成。术后1周所有患者的症状均有明显缓解，未见手术相关的并发症。随访6～24个月，平均15．6个月，VAS评分由术前的7．2分降至术后1周的2．6分，随访时为1．7分；直腿抬高试验及行走距离均有不同程度的改善，1例椎管狭窄的患者术后10d症状复发。结论：经皮穿刺等离子消融髓核成形术安全性好、操作简单，中期疗效满意，为腰腿痛的患者提供了一种新的微创治疗方法。

Treatment of low back pain (LBP) with coblation nucleoplasty

Objective:To study the clinical outcome of various low back pain (LBP) treated by coblationnucleoplasty.Method:Fourty- two patients with LBP were treated by coblation nucleoplasty.The clinical diagnosisconsisted of discogenic LBP(25 cases),disc herniation(12 cases) and lumbar stenosis(5 cases),all of thepatients were diagnosed by means of X- ray films,MRI and discography.Result:Coblation nucleopasties for allthe patients were successful.The follow- up period ranged from 6 to 24 months.The following parameters wererecorded before the operation,one week after operation and at the time of follow- up:VAS only for thediscogenic LBP group;VAS+straight leg raising for the disc herniation group;VAS+the walking distance for thegroup of lumbar stenosis.The mean VAS scores of all the patients were 7.2 before operation,2.6 one weekafter the operation,and 1.7 at the time of follow- up.The complications related to the surgery were not found.Conclusions:Coblation nucleoplasty is a safe,ease- doing and minimally invasive procedure with satisfactoryoutcome.It provides another alternative for the patients with LBP.