硬膜外粘连松解术治疗腰椎间盘突出症的疗效分析

摘要

Objectives:The aim of this clinic trial is to compare the effect of epidural neuroplasty (ENP) over transforaminal steroid epidural injection (TFSI) for the treatment of herniated lumbar disc (HLD). Method:Seventy-eight HLD patients were enrolled and assigned into two groups. The ENP group received ENP treatment (n= 27) and the TFSI group underwent TFSI treatment (n= 51). Visual analogue scale (VAS) and oswestry disability index (ODI) were recorded at baseline, 1 month, 3 months and 6 months after treat-ments.Results:Compared with the baseline level, the VAS and ODI scores in both ENP and TFSI groups were significantly improved at 1, 3, and 6 months after treatments. The VAS scores of ENP group were significantly lower than those of TFSI group at 3 months and 6 months follow-up. The ODI scores of ENP group were also significantly reduced compared with the TFSI group, at 1 month, 3 months and 6 months follow-up. The effec-tive rate in the ENP group was superior to those in the TFSI group.Conclusions:Both ENP and TFSI treat-ments were effective for the treatment of HLD. ENP treatment could produce superior effect over TFSI in terms of pain reduction and functional improvement.%目的:比较硬膜外粘连松解术(epidural neuroplasty,ENP)和经椎间孔硬膜外注射(transfo-raminal epidural steroid injection,TFSI)治疗腰椎间盘突出症(herniated lumbar disc,HLD)的疗效.方法:试验共纳入78名病人,按照病人意愿进行分组,试验组接受ENP治疗(ENP组,n=27),对照组接受TFSI治疗(TFSI组,n=51).两组病人术前、术后1月、3月、6月分别评估视觉模拟评分(visual analogue scale,VAS)和Oswestry功能障碍指数(oswestry disability index,ODI).结果:治疗前两组病人的VAS和ODI评分没有明显的差异.治疗后1个月、3个月、6个月两组病人均较治疗前显著改善(P<0.001).与TFSI组比较,ENP组术后3月和6月VAS评分显著下降(P<0.05);ENP组术后1月、3月、6月的ODI评分均显著低于TFSI组(P<0.05).ENP组术后6月总体有效率高于TFSI组,有显著统计学差异(P<0.05).结论:ENP和TFSI均能有效改善HLD病人的疼痛和功能,且ENP的疗效优于TFSI.