首页> 中文期刊> 《山东医药》 >背根神经节脉冲射频调节联合神经阻滞治疗腰椎手术失败综合征

背根神经节脉冲射频调节联合神经阻滞治疗腰椎手术失败综合征

         

摘要

Objective To investigate the clinical efficacy of pulsed radiofrequency modulation on dorsal root ganglion combined with nerve blocking for failed back surgery syndrome (FBSS). Methods Total of 83 patients suffered from FB-SS were randomized divided into two groups: control group ( n = 41) and treatment group ( n = 42 ). All the patients were punctured to the suffered dorsal root ganglion from the safety triangle approach using a 15 cm radiofrequency needle guided by C arm X-ray. In the control group, 5 mL anti-inflammatory and analgesia solution were injected to the dorsal root ganglion after successful puncture, while in the treatment group patients were treated by pulsed radiofrequency modulation on the dorsal root ganglion for 240 seconds (42 ℃ ), then injected 5 ml anti-inflammatory and analgesia solution. The visual analogue scale (VAS) was evaluated before the operation, 1 day, 1 month, 3 months and 6 months after the operation. All potential complications such as epidural infection and nerve injury were followed up after the operation. Results Although the VAS in both group were decreased significantly after treatment, compared with control group, patients in treatment group showed more pain relief at 3 and 6 months after the treatment(P<0. 05) , and no obvious nerve injury and epidural infection occured in both group. Conclusions Pulsed radiofrequency modulation on dorsal root ganglion for patients with FBSS can receive an exact short-term and long-term efficacy; It is a safety method to treat the FBSS patient.%目的 观察脉冲射频调节联合神经阻滞治疗腰椎手术失败综合征的疗效.方法 将83例腰椎手术失败综合征患者随机分为对照组41例和观察组42例,两组均于C型臂X线机透视下,用裸露段15 cm射频穿刺针经安全三角入路穿刺到受累阶段的椎间孔外口处,对照组仅注射消炎镇痛液5mL;观察组先行脉冲射频调节(42℃条件下)240 s,其后注射消炎镇痛液5 mL.治疗前及治疗后1d、1个月、3个月、6个月,分别采用Million等的视觉模拟量表法(VAS)判定腰痛程度;治疗后观察患者有无硬膜外感染、神经损伤等并发症发生.结果 治疗后1d、1个月、3个月和6个月两组VAS评分均明显低于治疗前(P均<0.05),其中观察组治疗后3个月和6个月VAS评分显著低于对照组(P分别<0.05、0.01);两组治疗后均无明显并发症发生.结论 背根神经节脉冲射频调节联合神经阻滞治疗腰椎手术失败综合征具有确切的近期和远期疗效,且安全性高.

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