C型臂X线机引导脊神经后内侧支阻滞松解术治疗小关节突源性下腰痛的疗效分析
摘要
目的探讨C型臂X线机引导下脊神经后内侧支阻滞松解术治疗小关节突源性下腰痛的有效性。方法纳入自2016-01—2017-01诊治的60例小关节突源性下腰痛,30例采用C型臂X线机引导脊神经后内侧支阻滞松解术治疗(观察组),30例口服塞来昔布治疗(对照组)。结果 60例均获得至少3个月随访,随访期间未出现并发症和药物不良反应。观察组治疗后1个月、3个月疼痛VAS评分、腰椎功能JOA评分均优于对照组,差异有统计学意义(P <0.05)。末次随访时MacNab评分:观察组优10例,良14例,可4例,差2例;对照组优6例,良9例,可11例,差4例;观察组末次随访时MacNab评分优于对照组,差异有统计学意义(P <0.05)。结论 C型臂X线机引导下脊神经后内侧支阻滞松解术操作简单,创伤小,近期疗效良好,是治疗小关节突源性下腰痛的有效方法之一。
引文
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[2]杨阳,金伟,查园瑜,等.脊柱内镜下脊神经背内侧支射频消融术治疗小关节源性腰痛疗效分析[J].临床外科杂志,2017,25(12):931-934.
[3]Cavanaugh JM,Ozaktay AC,Yamashita HT,et al.Lumbar facet pain:biomechanic s,neuroanatomy and neurophysiology[J].J Biomech,1996,29(9):1117-1129.
[4]Moseley GL,Hodges PW,Gandevia SC.Deep and superficial fibers of the lumbar multifidus muscle are differentially active during voluntary arm movements[J].Spine(Phila Pa 1976),2002,27(2):E29-36.
[5]Lau P,Mercer S,Govind J,et al.The surgical anatomy of lumbar medial branch neurotomy(facet denervation)[J].Pain Med,2010,5(3):289-298.
[6]郭雪娇,彭志友,冯智英.脊椎小关节介入治疗在慢性脊柱源性疼痛应用进展[J].中国疼痛医学杂志,2016,22(11):801-805.
[7]李鹏,杨春,蔡静桐,等.腰椎小关节周围脊神经后支内侧支分布的特点及其临床意义[J].局解手术学杂志,2017,26(8):552-555.
[8]Gries NC,Berlemann U,Moore RJ,et al.Early histologic changes in lower lumbar discs and facet joints and their correlation[J].Eur Spine J,2000,9(1):23-29.
[9]姚玉龙,贾惊宇,吴添龙,等.椎间孔镜下脊神经内侧支消融术治疗小关节源性下腰痛疗效分析[J].中国矫形外科杂志,2015,23(7):600-604.
[10]李志强,崔立刚,江凌,等.超声引导下选择性腰神经后内侧支介入治疗慢性腰痛的临床研究[J].中国超声医学杂志,2018,34(2):153-155.
[11]徐卫星,王健,丁伟国,等.去神经化治疗腰椎关节突关节源性腰痛的有效性与安全性研究[J].中国骨伤,2012,25(10):813-816.
[12]徐卫星,卢笛,丁伟国.C形臂透视引导针刀治疗腰椎关节突关节源性腰痛的临床研究[J].中华中医药杂志,2013,1(4):1136-1139.