Cohen Steven P, Larkin Thomas, Polly David W
Pain Management Center, Department of Anesthesiology, Walter Reed Army Medical Center, Washington, DC, USA.
J Spinal Disord Tech. 2002 Dec;15(6):537-41. doi: 10.1097/00024720-200212000-00020.
The introduction of intradiscal electrothermal therapy for the management of discogenic back pain has been met with intense interest over the past few years. During this time there have been several noncontrolled studies published on the procedure, most of which have shown excellent outcomes but few, if any, complications. The authors describe a 29-year-old, 152-kg active duty male soldier who underwent two-level intradiscal electrothermal therapy for L4-L5 and L5-S1 discogenic pain. Before the procedure, the patient had a small L5-S1 contained herniation, with no signs of radiculitis. Postprocedure, the patient developed radicular symptoms and was noted on MRI to have a large L5-S1 disc herniation effacing the left S1 nerve root. Follow-up discography revealed a negative discogram at L4-L5. The patient proceeded to undergo a single-level lumbar fusion, which resulted in nearly complete relief of his radicular and axial low back pain. Two years post-surgery, he is off all narcotic medications and continues to work full-time as a soldier. This case illustrates both the potential benefits and complications that may be associated with intradiscal electrothermal therapy.
在过去几年中，椎间盘内电热疗法用于治疗椎间盘源性下腰痛受到了广泛关注。在此期间，有多项关于该手术的非对照研究发表，其中大多数显示出良好的效果，但并发症极少，即便有也微乎其微。作者描述了一名29岁、体重152公斤的现役男性士兵，他因L4 - L5和L5 - S1椎间盘源性疼痛接受了两级椎间盘内电热疗法。手术前，患者有一个小型的L5 - S1包容性椎间盘突出，无神经根炎迹象。手术后，患者出现了神经根症状，MRI显示有一个大型的L5 - S1椎间盘突出，压迫左侧S1神经根。后续的椎间盘造影显示L4 - L5椎间盘造影为阴性。该患者随后接受了单节段腰椎融合术，其神经根性和轴性下腰痛几乎完全缓解。术后两年，他停用了所有麻醉药物，继续全职担任士兵工作。这个病例说明了椎间盘内电热疗法可能带来的潜在益处和并发症。
