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经皮椎间盘减压疗法治疗胸椎间盘突出症的疗效。

Effectiveness of Percutaneous Intradiscal Decompression Therapy in Thoracic Disc Herniation.

机构信息

Department of Anesthesiology and Reanimation, University of Health Sciences, Gülhane Training and Research Hospital, Ankara, Turkey

Department of Anesthesiology and Reanimation, Ankara University Faculty of Medicine Hospital, Ankara, Turkey

出版信息

Balkan Med J. 2019 Feb 28;36(2):134-138. doi: 10.4274/balkanmedj.galenos.2018.2018.0188. Epub 2018 Oct 9.

Abstract

AIMS

Although there have been many studies about lumbar and cervical ablation procedures, few studies have been performed in the thoracic region. To evaluate the clinical results of a percutaneous disc decompression device in patients with radicular symptoms and/or dorsal pain due to thoracic disc herniation.

METHODS

Eleven patients with thoracic disc herniation and/or degenerative discs (all in T10-T11, or T11-T12 levels) who did not respond to conservative treatments were undergoing ablation and compression procedures. Pain and radicular symptoms consistent with the thoracolumbar region were confirmed via abnormal magnetic resonance imaging findings after detailed anamnesis and physical examination. All patients were evaluated before and 1, 3, 6, and 12 months after treatment using the visual analog scale score. The patient satisfaction scale was used to evaluate the level of patient satisfaction at the end of the treatment at 12 months.

RESULTS

The median visual analog scale score was 7.00±0.45 points before treatment and 2.73±0.65 points at 12 months post-procedure and were statistically significant (p<0.001). The results of pairwise comparisons using the Bonferroni Corrected Wilcoxon Signed-Rank test showed that there were statistically significant differences. The mean visual analog scale score at the beginning (7.00±0.45) was significantly higher than the mean score of other months. Postoperative improvement was significant with a 99% confidence interval. No complications that may cause permanent damage occurred.

CONCLUSION

Percutaneous disc decompression is an effective and safe procedure to treat pain caused by lower thoracic intervertebral disc disease, which did not respond to conservative treatments.

摘要

目的

尽管已有许多关于腰椎和颈椎消融手术的研究,但针对胸椎区域的研究却很少。本研究旨在评估经皮椎间盘减压装置治疗因胸椎间盘突出症和/或背部疼痛引起的根性症状患者的临床效果。

方法

11 例胸椎间盘突出症和/或退行性椎间盘病变(均在 T10-T11 或 T11-T12 水平)患者,经保守治疗无效,接受了消融和减压手术。通过详细的病史询问和体格检查,结合异常磁共振成像结果,确认患者存在与胸腰椎区域一致的疼痛和根性症状。所有患者均在治疗前及治疗后 1、3、6 和 12 个月使用视觉模拟评分法(VAS)评估疼痛情况。在治疗结束后 12 个月使用患者满意度量表评估患者满意度。

结果

治疗前 VAS 中位数为 7.00±0.45 分,治疗后 12 个月为 2.73±0.65 分,差异具有统计学意义(p<0.001)。使用 Bonferroni 校正的 Wilcoxon 符号秩检验进行两两比较,结果显示差异具有统计学意义。采用 Bonferroni 校正的 Wilcoxon 符号秩检验进行两两比较,结果显示差异具有统计学意义。起始时 VAS 均值(7.00±0.45)明显高于其他月份的均值。术后改善明显,置信区间为 99%。未发生可能导致永久性损伤的并发症。

结论

经皮椎间盘减压术是一种治疗保守治疗无效的下胸椎间盘疾病引起疼痛的有效且安全的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d903/6409959/b75bd76411fe/BMJ-36-134-g4.jpg

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