Park J, Park J Y, Kim S H, Lim D J, Kim S D, Chung H S
Department of Neurosurgery, Korea University Ansan Hospital, Korea University School of Medicine, Ansan, Korea.
Acta Neurochir Suppl. 2006;99:81-3. doi: 10.1007/978-3-211-35205-2_16.
We report on our experience of percutaneous radiofrequency neurotomy (PRN) on the posterior primary ramus (PPR) with at least two years follow-up.
228 patients underwent PRN on the PPR for refractory low back pain. 128 patients met the inclusion criteria of facetal originated pain (group II), while 100 patients did not (group I). Radiofrequency (RF) procedures were applied in the usual manner. Pain relief was assessed at 1 week, 1 month, 6 months and 2 years using visual analog scale (VAS).
Positive responders were 56% at 1 week, 46% at 1 month, 18% at 6 months, and 13% at 2 years after PRN in group I, and 78.9% at 1 week, 75.4% at 1 month, 62.5% at 6 months, and 54.7% at 2 years in group II. Prominent local tenderness, percussion tenderness, pain on getting up, extension and transitional movement, radiating pain on buttock and/or posterior thigh, and good immediate response were found to be significantly related to good outcome.
PRN on the PPR has long-term beneficial effects. Long-term good results can be achieved after proper selection of patients with facet joint related low back pain.
我们报告经皮射频神经切断术(PRN)治疗后支(PPR)的经验,随访时间至少两年。
228例患者接受了PPR的PRN治疗难治性腰痛。128例患者符合小关节源性疼痛的纳入标准(II组),而100例患者不符合(I组)。以常规方式进行射频(RF)手术。使用视觉模拟量表(VAS)在1周、1个月、6个月和2年时评估疼痛缓解情况。
I组PRN后1周时阳性反应者为56%,1个月时为46%,6个月时为18%,2年时为13%;II组1周时为78.9%,1个月时为75.4%,6个月时为62.5%,2年时为54.7%。发现明显的局部压痛、叩击痛、起床时疼痛、伸展和过渡运动时疼痛、臀部和/或大腿后侧放射痛以及良好的即时反应与良好的预后显著相关。
PPR的PRN具有长期有益效果。正确选择与小关节相关的腰痛患者后可取得长期良好效果。