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靶点射频联合胶原酶化学溶解术治疗腰椎间盘突出症

Target radiofrequency combined with collagenase chemonucleolysis in the treatment of lumbar intervertebral disc herniation.

作者信息

Zhang Daying, Zhang Yong, Wang Zhijian, Zhang Xuexue, Sheng Mulan

机构信息

Department of Pain, The First Affiliated Hospital of Nanchang University Nanchang 330006, China.

Department of Pain, The Third Hospital of Nanchang Nanchang 330009, Jiangxi Province, China.

出版信息

Int J Clin Exp Med. 2015 Jan 15;8(1):526-32. eCollection 2015.

Abstract

Both target radiofrequency thermocoagulation and collagenase chemonucleolysis are effective micro-invasive therapy means for lumbar intervertebral disc herniation. In order to analyze the clinical effects of target radiofrequency thermocoagulation combined with collagenase chemonucleolysis on lumbar intervertebral disc herniation, the contents of hydroxyproline and glycosaminoglycan were measured and the histological changes of nucleus pulposus was detected in the vitro experiments. Radiofrequency thermocoagulation reduced the hydrolyzation of herniated nucleus pulposus caused by collagenase, as well as the content of hydroxyproline and glycosaminoglycan. Furthermore, 236 patients with lumbar intervertebral disc herniation were treated by target radiofrequency thermocoagulation combined with collagenase chemonucleolysis. The efficiency was evaluated according to Macnab criteria, and the index of lumbar disc herniation (IDH) was compared pre-operation with 3 months post-operation. The post-operative good rate was 66.5% (157/236) at 2 weeks post-operation, and 88.1% (208/236) at 3 months post-operation. In the post-operative follow-up exam, 86.8% of the re-examined cases demonstrated smaller or ablated protrusion, with reduced IDH values from pre-operation, which was statistically significant. No serious complications were detected intra-operatively and post-operatively. In conclusion, target radiofrequency combined with collagenase chemonucleolysis was an effective and safe method for treatment of lumbar intervertebral disc herniation.

摘要

靶点射频热凝术和胶原酶化学溶解术都是治疗腰椎间盘突出症有效的微创治疗手段。为分析靶点射频热凝术联合胶原酶化学溶解术治疗腰椎间盘突出症的临床效果,在体外实验中检测了羟脯氨酸和糖胺聚糖的含量,并观察了髓核的组织学变化。射频热凝术可减少胶原酶引起的突出髓核水解,以及羟脯氨酸和糖胺聚糖的含量。此外,对236例腰椎间盘突出症患者采用靶点射频热凝术联合胶原酶化学溶解术进行治疗。根据Macnab标准评估疗效,并比较术前和术后3个月的腰椎间盘突出症指数(IDH)。术后2周时,术后优良率为66.5%(157/236),术后3个月时为88.1%(208/236)。在术后随访检查中,86.8%的复查病例显示突出物缩小或消失,IDH值较术前降低,差异有统计学意义。术中及术后均未发现严重并发症。综上所述,靶点射频联合胶原酶化学溶解术是治疗腰椎间盘突出症的一种有效且安全的方法。

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