颈前入路射频联合盘内小剂量胶原酶注射治疗颈椎间盘突出症.pdf

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1、ChineseJourna1ofPainMedicine2015．21f2——doi：10．39690．issn．1006—9852．2015．02．010颈前入路射频联合盘内小剂量胶原酶注射治疗颈椎问盘突出症张达颖王志剑张学学喻燕波章勇(南昌大学第一附属医院疼痛科，南昌330006)摘要目的：观察和分析颈前入路射频联合盘内小剂量胶原酶注射治疗颈椎间盘突出症的临床效果。方法：对43例颈椎间盘突出症患者经颈前入路穿刺行射频联合盘内小剂量胶原酶注射术。采用视觉模拟评分法(visualanaloguescale，VAS)评定术前与术后7天疼痛程度。术后3月、12月随访，采用JOA(

2、JapaneseOrthopaedicAssociation)评分标准评定术后神经功能改善率。应用MRI影像信息系统(picturearchivingandcommunicationsystems，PACS)测量并比较术前及术后3月突出物面积大小。结果：术后7天VAS评分较术前减低，其间有统计学差异(P<0．01)。术后3月、12月JOA标准评定优良率分别为93．0％、90．7％，其间无统计学差异(P>0．05)。术后3月MRI突出物面积较术前明显减少，具有统计学差异(P<0．01)。各例术中及术后均无严重并发症发生。结论：颈前入路射频联合盘内小剂量胶原酶注射术是治疗颈椎间盘

3、突出症有效而安全的方法。关键词射频；胶原酶；颈椎间盘突出症TREATGT衄CERⅥCALTERTEBRALDIsCI

4、口IIATIoNWITHRADIoFIOUENCYCoMBINED、VITHSMALLDOSECoLLAGENASEINJECTEDINTOINTERRIoRoFDISCVIAANTEluoRCERVICALAPPRoACHZHANGDa—YinWANGZhi．Jian，ZHANGXue．Xue，YUYan．Bo，ZHANGYong【DepartmentofPain，TheFirstA佑liatedHospitalofNanChangUniversity，Na

5、nchang330006)Abstract0bjective：Toobservethetherapeuticeffectofradiofrequencycombinedwithsmalldosecollagenaseinjectedintointeriorofdiscviaanteriorcervicalapproachoncervicalintervertebraldischerniation．Methods：Forty—threepatientswithcervicalintervertebraldischerniationreceivedradiofrequencyco

6、mbinedwithcollagenase(60-100U)injectionviaanteriorcervicalapproach．TheameliorationofnervefunctionwereassessedbythecurrentJapaneseOrthopaedicAssociation(JOA)scoringsystemat3and12monthsafteroperation．Visualanaloguescale(VAS)wasusedtoevaluatethedegreeofpainbetweenpre．．operationand7daysafterope

7、ration．Theareaofprotrusionbetweenpre—operationand3monthsafteroperationweremeasuredandcomparedbyMRIpicturearchivingandcommunicationsystems(PACS)．Results：Comparedwithpre．operation，thepaindegreeonthe7thdayafleroperationweresignificantlyreducedfP<0．01)．Allcaseswerefollowedupat3andl2mortthsafter

8、operation，theexcellentandgoodratesofnervefunctionameliorationwere93．0％，90．7％，respectively．Twenty-sevencasesfollowedupat3monthsafteroperationwereobservedwithreducedprotrusionbymeasuringtheareaofprotrusionfP<0．01)．Therewerenoseveresideeffectsobservedinthis