CT引导下选择性神经根阻滞治疗腰椎间盘突出症的疗效和相关因素分析

摘要

目的:观察CT引导下选择性神经根阻滞治疗腰椎间盘突出症的疗效和相关影响因素.方法:32例腰椎间盘突出症患者,在CT引导下行选择性神经根阻滞术.应用疼痛视觉模拟评分(VAS)评价治疗效果并回顾性分析椎间盘突出节段、突出位置、突出程度和阻滞节段对疗效的影响.结果:术前和术后平均VAS评分分别为7.38 4±1.13分和2.06±2.00分,二者差异有统计学意义(P<0.01).侧后方椎间盘突出的治疗效果优于正后方椎间盘突出(P<0.05);轻度椎间盘突出的治疗效果优于中度椎间盘突出(P<0.05);采用双节段阻滞治疗正后方椎间盘突出的效果好于单节段阻滞(P<0.05).腰椎不同节段间和不同神经根间阻滞的效果无统计学意义(P>0.05).结论:CT引导下选择性神经根阻滞在腰椎间盘突出症的治疗上安全有效.术前明确椎间盘突出情况,选择不同阻滞节段可以指导腰椎间盘突出症的治疗预后.%Objective: To observe the therapeutic effect and related factors of CT-guided selective nerve root block in lumbar intervertebral disc herniation. Methods: 32 patients with lumbar intervertebral disc herniation underwent CT-guided selective nerve root block procedure. Visual Analogue Scale (VAS) was used to evaluate pain relief. Therapeutic effects on the herniation segment, herniation location, herniation morphology and block segment retrospectively were also measured. Results: The mean VAS of pre- and postoperation was 7.38 ± 1.13 and 2.06 ±2.00, respectively (P ＜0.01 ). The therapeutic effect for lateral disc herniation was better than the central. Cases with mild herniation were better than the moderateones. For the central herniation group, the therapeutic effect of bi-segmental block is better than the single segment block. The differences were statistically significant ( P ＜ 0.05 ). No significant difference was found whether the herniation occured in different segments (P ＞ 0.05 ). Conclusion: CT-guided selective nerve root block in lumbar intervertebral disc herniation is safe and effective. Pre-operative clarification of disc herniation details and choosing different block segments may improve treatment outcome.