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射频靶点椎间盘减压术与经皮激光椎间盘减压术治疗腰椎间盘突出症疗效的五年随访综合比较

Comprehensive comparison of therapeutic efficacy of radiofrequency target disc decompression and nucleoplasty for lumbar disc herniation: a five year follow-up.

作者信息

Nie Hui-Yong, Qi Ya-Bin, Li Na, Wang Suo-Liang, Cao Yong-Xiao

机构信息

Department of Rehabilitation Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China.

Department of Pharmacology, Xi'an Jiaotong University Health Science Center, 76 Yanta West Road, Xi'an, 710061, China.

出版信息

Int Orthop. 2018 Apr;42(4):843-849. doi: 10.1007/s00264-017-3661-5. Epub 2017 Oct 31.

DOI:10.1007/s00264-017-3661-5
PMID:29090325
Abstract

PURPOSE

To compare the therapeutic efficacy of radiofrequency target disc decompression(TDD) and nucleoplasty for lumbar disc herniation.

METHODS

Two hundred sixty patients with lumbar disc herniation were divided into two groups: target disc decompression group (group T, n = 147) and nucleoplasty group (group N, n = 113). Visual analogue scale (VAS) and functional rating index (FRI) were measured at one, three, six, 12, 24, and 60 months after the surgery. Hospitalization time, operation time, complications, and recurrence/invalid were compared between the two groups.

RESULTS

Compared with the pre-operation, the VAS and FRI in both groups were significantly decreased in post-operation(P < 0.01). The VAS and FRI in group T have no significant difference compared to those in group N. The hospitalization and operation time of group T were significantly longer than those in group N. There was no significant difference of the occurrence of complications and disease recurrence/invalid during the follow-up between the two groups. Logstic regression analysis showed that operation time was an independent factor in the prognosis. Operation time affects the treatment effect. Shorter operation time leads to better therapeutic efficacy, and longer operation time leads to poor therapeutic efficacy.

CONCLUSIONS

Both TDD and nucleoplasty can reduce pain in patients with lumbar disc herniation and improve quality of life. Group N had shorter hospitalization and operation time than group T.

摘要

目的

比较射频靶点椎间盘减压术(TDD)与经皮激光椎间盘减压术治疗腰椎间盘突出症的疗效。

方法

将260例腰椎间盘突出症患者分为两组:靶点椎间盘减压组(T组,n = 147)和经皮激光椎间盘减压组(N组,n = 113)。在术后1、3、6、12、24和60个月测量视觉模拟评分(VAS)和功能评分指数(FRI)。比较两组的住院时间、手术时间、并发症及复发/无效情况。

结果

与术前相比,两组术后VAS和FRI均显著降低(P < 0.01)。T组与N组的VAS和FRI无显著差异。T组的住院时间和手术时间显著长于N组。两组随访期间并发症的发生及疾病复发/无效情况无显著差异。Logstic回归分析显示手术时间是预后的独立因素。手术时间影响治疗效果。手术时间越短,治疗效果越好;手术时间越长,治疗效果越差。

结论

TDD和经皮激光椎间盘减压术均可减轻腰椎间盘突出症患者的疼痛,提高生活质量。N组的住院时间和手术时间比T组短。

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