Zhou Qin, Zhou Fang, Wang Long, Liu Kang
Department of Anesthesiology, Renmin Hospital of Wuhan University, 238 #Jie Fang road Wu Chang, Wuhan 430060, Hubei Province, People's Republic of China.
Department of Anesthesiology, Renmin Hospital of Wuhan University, 238 #Jie Fang road Wu Chang, Wuhan 430060, Hubei Province, People's Republic of China.
Clin Neurol Neurosurg. 2016 Sep;148:115-20. doi: 10.1016/j.clineuro.2016.07.018. Epub 2016 Jul 11.
This study aims to observe the clinical efficacy and feasibility of improved X-rays-guided radiofrequency thermocoagulation denervation for treating low back pain secondary to lumbar facet joint syndrome (LFJS).
Eighty LFJS patients were randomly assigned into two groups: the denervation group (n=40), treated with percutaneous radiofrequency thermocoagulation denervation on the lumbar facet joint, and the control group (n=40), injected with betamethasone and lidocaine into the lumbar facet joint. All patients underwent pain scoring using the visual analogous scale (VAS) before treatment, and again at 30 min, 1 d, 1 week, 1 month, and 6 months after treatment. The Schober index was also evaluated at 1 week, 1 month, and 6 months after treatment. The efficacy and adverse effects were also recorded.
The denervation group had significantly lower VAS scores at each time point than before treatment (P<0.01). The VAS scores in the control group at 30min, 1d, 1 week, and 1 month after treatment were also significantly lower, but they returned to the pre-treatment level at 6 months after treatment. The VAS scores in the denervation group were significantly lower than that in the control group at 1 month and at 6 months after treatment (P<0.05 and P<0.01), whereas the Schober index was significantly higher (P<0.01). Moreover, the excellent to good efficacy rate in the denervation group was higher than that in the control group (P<0.01). The patients in both treatments had no side effects.
Improved X-rays-guided radiofrequency thermocoagulation denervation is an effective, minimally invasive and convenient method for treating low back pain secondary to lumbar facet syndrome.
本研究旨在观察改良X线引导下射频热凝去神经术治疗腰椎小关节综合征（LFJS）继发下腰痛的临床疗效及可行性。
80例LFJS患者随机分为两组：去神经组（n = 40），采用经皮腰椎小关节射频热凝去神经术治疗；对照组（n = 40），向腰椎小关节内注射倍他米松和利多卡因。所有患者在治疗前、治疗后30分钟、1天、1周、1个月和6个月时采用视觉模拟评分法（VAS）进行疼痛评分。在治疗后1周、1个月和6个月时还评估了Schober指数。记录疗效及不良反应。
去神经组各时间点的VAS评分均显著低于治疗前（P < 0.01）。对照组在治疗后30分钟、1天、1周和1个月时的VAS评分也显著降低，但在治疗后6个月时恢复到治疗前水平。去神经组在治疗后1个月和6个月时的VAS评分显著低于对照组（P < 0.05和P < 0.01），而Schober指数显著更高（P < 0.01）。此外，去神经组的优良率高于对照组（P < 0.01）。两种治疗方法的患者均无副作用。
改良X线引导下射频热凝去神经术是治疗腰椎小关节综合征继发下腰痛的一种有效、微创且便捷的方法。
