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通道系统联合臭氧治疗对中央型L3-L4腰椎间盘突出症行腰椎椎间融合术的临床疗效

Clinical efficacy of lumbar interbody fusion using a channel system combined with ozone therapy for the treatment of central-type L3-L4 lumbar disc herniation.

作者信息

Wang Yu, Sun Hong, Qin Shuzhen

机构信息

Department of Orthopedics, Rizhao Hospital of Traditional Chinese Medicine, Rizhao, Shandong 276800, P.R. China.

Department of Anesthesiology, People's Hospital of Rizhao, Rizhao, Shandong 276800, P.R. China.

出版信息

Exp Ther Med. 2017 Feb;13(2):619-623. doi: 10.3892/etm.2016.4009. Epub 2016 Dec 29.

Abstract

The clinical efficacy of minimally invasive lumbar interbody fusion via the intervertebral foramen combined with ozone (O) therapy for the treatment of L3-L4 central-type lumbar disc herniation was explored. We recruited patients with sciatica who attended our hospital between July 2013 and October 2015 and underwent lumbar X-ray (anteroposterior and lateral view), lumbar flexion-extension radiographs, computed tomography, and magnetic resonance imaging after admission. Seventy-four patients with central-type lumbar disc herniation but no other complications were randomly selected and divided into the observation and control groups. The observation group comprised 37 patients treated with lumbar fusion using a channel system combined with O therapy, whereas the control group comprised 37 patients treated with lumbar fusion alone. The effects of the two therapies were evaluated using visual analog scale, Japanese Orthopaedic Association, and MacNab scores. There was no significant difference in scores between the two groups before surgery (P>0.05). The scores of the observation group after treatment were significantly lower than those before surgery and those of the control group (P<0.05). One patient in the observation group experienced no obvious improvement in symptoms after surgery, and two patients in the control group experienced postoperative recurrence; these three patients subsequently underwent laminectomy combined with planted bone fusion and internal fixation. There was no significant difference in total efficacy rates between the two groups (P>0.05). Lumbar fusion using a channel system combined with O therapy for the treatment of L3-L4 central-type lumbar disc herniation is safe and effective. It has the advantages of reduced trauma, fewer complications, and rapid pain relief, and it promotes the recovery of lumbar function. Strict mastery of the surgical indications is key to the success of the procedure; however, it is worth expanding its use in the clinical setting.

摘要

探讨经椎间孔微创腰椎椎间融合联合臭氧(O)治疗L3-L4中央型腰椎间盘突出症的临床疗效。我们纳入了2013年7月至2015年10月期间在我院就诊且患有坐骨神经痛的患者,入院后进行了腰椎X线(正位和侧位片)、腰椎屈伸位X线片、计算机断层扫描和磁共振成像检查。随机选取74例无其他并发症的中央型腰椎间盘突出症患者,分为观察组和对照组。观察组37例患者采用通道系统腰椎融合联合O治疗,对照组37例患者仅采用腰椎融合治疗。采用视觉模拟评分、日本骨科学会评分和MacNab评分评估两种治疗方法的效果。两组术前评分差异无统计学意义(P>0.05)。观察组治疗后的评分显著低于术前及对照组(P<0.05)。观察组1例患者术后症状无明显改善,对照组2例患者术后复发;这3例患者随后接受了椎板切除术联合植骨融合内固定术。两组总有效率差异无统计学意义(P>0.05)。采用通道系统腰椎融合联合O治疗L3-L4中央型腰椎间盘突出症安全有效。具有创伤小、并发症少、疼痛缓解快的优点,促进腰椎功能恢复。严格掌握手术适应证是手术成功的关键;然而,值得在临床中扩大其应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5909/5348654/8d46b78bf462/etm-13-02-0619-g00.jpg

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