选择性神经根封闭术在腰椎退变性疾病中的应用

目的探讨选择性神经根封闭术在腰椎退变性疾病中的定位诊断作用。方法 2008年1月～2010年12月共收治多节段腰椎退变患者58例。多节段腰椎椎管狭窄症患者共32例,其中男20例,女12例;年龄55～75岁,平均64岁;病程1～11年。多节段腰椎椎间盘突出患者26例,其中男15例,女11例;年龄38～63岁,平均45岁;病程1～8年。以上患者均有下肢疼痛不适症状。所有患者均采用选择性神经根封闭术明确责任节段。结果 32例多节段腰椎椎管狭窄症患者中25例行>2个节段的减压术;26例多节段腰椎椎间盘突出患者,12例行单节段髓核切除,另14例行双节段髓核切除。责任间隙准确,患者疗效良好。结论在腰椎退变性疾病的定位诊断中,选择性神经根封闭是一种准确而有效的确认责任间隙的方法。

Application of selective nerve root block in treatment of lumbar degenerative diseases

Objective To explore the value of selective nerve root block in the treatment of lumbar degenerative diseases. Meth- ods Thirty-two cases of multi-segment degenerated lumbar spinal stenosis were treated from January 2009 to December 2011. There were 20 males and 12 females with the mean age of 64 years old. Twenty-six cases of multi-segment lumbar disc herniation were trea-ted at the same time. There were 15 males and 11 females with the mean age of 45 years old. All the cases were suffered from leg pain. Selective nerve root block was used in all cases to identify the responsible segments. Results Based on the results, surgical treatment was carried out. Of all cases of multi-segment degenerated lumbar spinal stenosis, 25 cases were received 〉 2 segments decompression. Of all cases of multi-segment lumbar disc herniation, 12 cases were received single segment of the nucleus pulposus resection and other 14 cases were received double segments of the nucleus pulposus resection. The responsible segments were accu- rate, and therapeutic effects were good. Conclusion Selective nerve root block is an effective and accurate method to identify the responsible segment in the treatment of lumbar degenerative diseases.