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非包容性腰椎间盘突出症的臭氧化学髓核溶解术:一项为期12个月随访的初步研究。

Ozone chemonucleolysis in non-contained lumbar disc herniations: a pilot study with 12 months follow-up.

作者信息

Buric J, Molino Lova R

机构信息

Unità Funzionale di Chirurgia Spinale c.d.c. Villanova, Florence, Italy.

出版信息

Acta Neurochir Suppl. 2005;92:93-7. doi: 10.1007/3-211-27458-8_20.

Abstract

STUDY DESIGN

Prospective case series with six and twelve months follow up.

OBJECTIVE

To observe clinical and morphological results of the intradiscal ozone chemionucleolysis in patients affected by non-contained lumbar disc herniations.

METHODS

30 patients were included in the study on the base of precise inclusion and exclusion criteria. The patients were followed on 6 and 12 months period by Visual Analogic Scale (VAS), Roland Morris Disability Questionnaire (RMDQ) and Overall Patient Rating Scale (OPRS). Disc herniation volume morphology was evaluated at 5 months by control MRI scanning.

RESULTS

Twenty-seven patients (90%) showed a statistically significant improvement in pain (P < 0.001, Wilcoxon test) and function (P < 0.001, Wilcoxon test), on VAS and RMDQ evaluation, respectively. The mean satisfaction with the treatment on OPSR was 79.3%, with 24 patients referring satisfaction equal or greater than 80%. There were no major complications related to the procedure.

CONCLUSIONS

The results of this study indicate the ozone chemonucleolysis as a possibly effective modality of treatment in patients affected by signs and symptoms of non-contained lumbar disc herniations that have overpassed conservative measures and have not yet fulfilled the indications for open surgical treatment.

摘要

研究设计

前瞻性病例系列研究,随访6个月和12个月。

目的

观察非包容性腰椎间盘突出症患者椎间盘内臭氧化学髓核溶解术的临床和形态学结果。

方法

根据精确的纳入和排除标准,30例患者纳入本研究。通过视觉模拟量表(VAS)、罗兰·莫里斯残疾问卷(RMDQ)和患者总体评定量表(OPRS)对患者进行6个月和12个月的随访。在5个月时通过对照MRI扫描评估椎间盘突出体积形态。

结果

在VAS和RMDQ评估中,分别有27例患者(90%)在疼痛(P < 0.001,Wilcoxon检验)和功能(P < 0.001,Wilcoxon检验)方面显示出统计学上的显著改善。在OPSR上对治疗的平均满意度为79.3%,24例患者表示满意度等于或大于80%。该手术未发生重大并发症。

结论

本研究结果表明,对于非包容性腰椎间盘突出症体征和症状的患者,臭氧化学髓核溶解术可能是一种有效的治疗方式,这些患者已超过保守治疗措施且尚未达到开放手术治疗的指征。

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