DSA引导下经骶裂孔硬膜外腔导丝松解联合硬膜囊前间隙阻滞治疗腰椎间盘突出症的疗效

摘要

目的 研究经骶裂孔硬膜外腔导丝松解联合硬膜囊前间隙阻滞治疗腰椎间盘突出症的疗效.方法 选择腰椎间盘突出症患者60例,随机分为A、B两组,每组30例.A组经骶裂孔硬膜外腔导丝松解联合硬膜囊前间隙阻滞治疗;B组经椎间孔入路硬膜外腔阻滞治疗.观察治疗前、治疗后1d、15d、1个月、2个月时的VAS评分;采用改良MacNab法于治疗后3个月、6个月时进行疗效评价.结果 两组治疗后各观察点VAS评分均显著下降,疼痛程度均明显改善(P＜0.05);2个月时A组疼痛评分较B组减轻更明显,差异有统计学意义(P＜0.05).治疗后3个月时,A组优良率为90.0％,B组优良率为86.7％(P＞ 0.05);6个月时,A组优良率为77.3％,B组优良率为50.0％(P＜0.05).结论 经骶裂孔硬膜外腔导丝松解联合硬膜囊前间隙阻滞治疗腰椎间盘突出症,近期疗效肯定.%Objective To observe the efficacy of epidural HiWire filament lysis via sacral hiatus combined with epidural anterior space block under DSA guidance in the treatment of patients with lumbar intervertebral disc herniation.Methods Sixty patients with lumbar intervertebral disc herniation were divided into group A and group B randomly,30 cases in each group.The patients were received epidural HiWire filament lysis via sacral hiatus combined with epidural anterior space block in group A,epidural block via intervertebral foramen in group B.The analgesic efficacy was evaluated with visual analogue scale (VAS) at pre-treatment and 1 d,15 d,1 month and 2 months after the treatment.The modified MacNab was applied to evaluate the effect at 3 months and 6 months after the treatment.Results The VAS decreased significantly at different time point after the treatment.The pain degree improved obviously in the two groups as compared with pre-treatment (P＜ 0.05).The VAS was lower in group A than that in group B at 2 months after the treatment (P＜ 0.05).The excellent and good rate was 90.0％ in group A,and 86.7％ in group B (P＞ 0.05)at 3 months after the treatment,and 77.3％,50.0％ at 6 months respectively after the treatment (P＜ 0.05).Conclusion Epidural HiWire filament lysis via sacral hiatus combined with epidural anterior space block under DSA guidance is effective in the treatment of patients with lumbar intervertebral disc herniation.