Disc-FX 系統(tǒng)輔助下經(jīng)皮髓核鉗夾術(shù)并射頻消融術(shù)治療椎間盤源性腰痛

·臨床研究·

Disc-FX系統(tǒng)輔助下經(jīng)皮髓核鉗夾術(shù)并射頻消融術(shù)治療椎間盤源性腰痛

張景川,蘇再發(fā),蘇昭元,林棟

作者單位：362000福建，泉州市中醫(yī)院骨傷科

【摘要】目的觀察Disc-FX系統(tǒng)輔助下經(jīng)皮髓核鉗夾術(shù)、射頻消融術(shù)治療椎間盤源性腰痛的的臨床療效。方法2010年6月～2011年5月，采用Disc-FX系統(tǒng)輔助下經(jīng)皮髓核鉗夾術(shù)、射頻消融術(shù)治療并獲得隨訪椎間盤源性腰痛53例，男24例，女29例；年齡29～56歲，中位年齡38歲。對(duì)術(shù)前和術(shù)后1周、6個(gè)月、12個(gè)月、18個(gè)月及24個(gè)月隨訪采用疼痛視覺模擬量表(visual analogue scales, VAS)評(píng)分和Oswestry功能障礙指數(shù)(Oswestry disability index, ODI)評(píng)價(jià)臨床療效。末次隨訪按改良Macnab標(biāo)準(zhǔn)評(píng)價(jià)臨床療效。結(jié)果術(shù)后1周、6個(gè)月、12個(gè)月及24個(gè)月ODI和VAS評(píng)分與術(shù)前相比，差異均有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論Disc-FX系統(tǒng)輔助下采用經(jīng)皮髓核鉗夾、射頻消融等綜合技術(shù)治療椎間盤源性腰痛療效良好。

【關(guān)鍵詞】腰椎; 椎間盤; 腰痛; 導(dǎo)管消融術(shù); 椎間盤切除術(shù)， 經(jīng)皮; 外科手術(shù)，計(jì)算機(jī)輔助

作者簡(jiǎn)介：張景川(1971— )， 學(xué)士，主治醫(yī)師

【中圖分類號(hào)】R 681.533【文獻(xiàn)標(biāo)志碼】 A

DOI【】

收稿日期：(2013-09-20)

Percutaneous nucleus pulposus clamping and radiofrequency ablation assisted by Disc-FX system for treatment of discogenic low back painZHANGJing-chuan,SUZai-fa,SUZhao-yuan,LINDong.DepartmentofOrthopaedicsandTraumatology,QuanzhouHospitalofTraditionalChineseMedicine，Quanzhou362000,Fujian,China

Abstract【】ObjectiveTo investigate the clinical efficacy of percutaneous nucleus clamping and radiofrequency ablation assisted by Disc-FX system for the treatment of discogenic low back pain, and to provide the basis for clinical therapy. MethodsFrom June 2010 to May 2011, 53 cases with discogenic low back pain underwent percutaneous nucleus clamping technique and radio frequency ablation assisted by Disc-FX system, and were followed up, including 24 males and 29 females, and with the median was 38 years old (ranged 29-56 years).Visual analogue scales(VAS) score and Oswestry disability index(ODI) were used to evaluate the clinical curative effect at preoperative, postoperative 1 week, 6 months, 12 months, 18 months and 24 months. At the final follow-up, the clinical effect was also evaluated according to Macnab standard.Results The ODI and VAS score at postoperative 1 week ,6 months, 12 months and 24 months had significant differences compared with preoperative data (P<0.05). ConclusionComprehensive treatment including percutaneous nucleus clamping and radiofrequency ablation assisted by Disc-FX system have a good clinical curative effect for low back pain.

【Key words】Lumbar vertebrae; Intervertebral disk; Low back pain; Catheter ablation; Diskectomy, percutaneous; Surgery, computer-assisted

J Spinal Surg， 2015， 13(1):7-10

椎間盤源性腰痛是指由于一個(gè)或多個(gè)椎間盤內(nèi)部結(jié)構(gòu)和代謝功能異常(如退變、終板損傷或纖維環(huán)內(nèi)裂釋放出某些因子刺激椎間盤纖維內(nèi)疼痛感受器)所引起的腰痛，不伴神經(jīng)根性癥狀或節(jié)段間過度活動(dòng)的影像學(xué)表現(xiàn)。隨著對(duì)椎間盤源性腰痛發(fā)生機(jī)制的深入了解和現(xiàn)代醫(yī)學(xué)的發(fā)展，微創(chuàng)介入療法已廣泛應(yīng)用于頑固性椎間盤源性疼痛的治療，如椎間孔鏡、椎間盤內(nèi)亞甲藍(lán)注射[1]、熱療、射頻消融、激光汽化、臭氧氧化術(shù)等已在國(guó)內(nèi)外廣泛使用，近期療效滿意，但遠(yuǎn)期療效尚不明確。2010年6月～2011年2月，經(jīng)過嚴(yán)格篩選，本院采用Disc-FX系統(tǒng)治療中青年椎間盤源性腰痛患者53例，療效滿意，現(xiàn)總結(jié)報(bào)告如下。……