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单次腰椎经椎间孔硬膜外类固醇注射治疗L4-5和L5-S1旁中央型椎间盘突出症的疗效比较

Comparison of the Effect of Single Lumbar Transforaminal Epidural Steroid Injections for the Treatment of L4-5 and L5-S1 Paramedian Disc Herniation.

作者信息

Adilay Utku, Guclu Bulent, Deniz Levent, Kahveci Ramazan

机构信息

Balikesir University, School of Medicine, Department of Neurosurgery, Balikesir, Turkey.

出版信息

Turk Neurosurg. 2019;29(2):279-284. doi: 10.5137/1019-5149.JTN.24029-18.1.

Abstract

AIM

To compare the outcomes of fluoroscopically guided transforaminal epidural steroid injections between L4-L5 paramedian disc herniation and L5-S1 paramedian disc herniation for the treatment of radicular pain.

MATERIAL AND METHODS

A total of 593 patients treated by transforaminal epidural steroid injections for the treatment of L4-5 paramedian disc herniation and 504 patients treated by transforaminal epidural steroid injections for the treatment of L5-S1 paramedian disc herniation were included in the study. All the patients were regularly followed up for 12 weeks. Preprocedural Visual Analogue Scale (VAS) scores, 12-week post-procedural VAS scores and complications were recorded.

RESULTS

The mean preprocedural and postprocedural VAS scores for L4-5 paramedian disc herniation were 63.09 ± 5.37 and 15.81 ± 3.58, respectively, and the mean preprocedural and postprocedural VAS scores for L5-S1paramedian disc herniation were 61.15 ± 5.45 and 27.06 ± 3.62, respectively, for radicular pain. There was a statistically significant difference between preprocedural and postprocedural VAS scores for L4-5 and L5-S1 paramedian disc herniation (p < 0.05). Transforaminal epidural steroid injections for L4-5 paramedian disc herniation were more effective than transforaminal epidural steroid injections for L5-S1 paramedian disc herniation.

CONCLUSION

This study showed that transforaminal epidural steroid injections for L4-5 paramedian disc herniation were more effective than transforaminal epidural steroid injections for L5-S1 paramedian disc herniation in the 12-week follow-up period.

摘要

目的

比较在荧光透视引导下经椎间孔硬膜外注射类固醇治疗L4-L5椎间孔旁椎间盘突出症与L5-S1椎间孔旁椎间盘突出症引起的神经根性疼痛的疗效。

材料与方法

本研究纳入了593例接受经椎间孔硬膜外注射类固醇治疗L4-5椎间孔旁椎间盘突出症的患者以及504例接受经椎间孔硬膜外注射类固醇治疗L5-S1椎间孔旁椎间盘突出症的患者。所有患者均接受了为期12周的定期随访。记录术前视觉模拟评分(VAS)、术后12周VAS评分及并发症情况。

结果

L4-5椎间孔旁椎间盘突出症患者术前和术后VAS评分的平均值分别为63.09±5.37和15.81±3.58,L5-S1椎间孔旁椎间盘突出症患者术前和术后VAS评分的平均值分别为61.15±5.45和27.06±3.62,用于评估神经根性疼痛。L4-5和L5-S1椎间孔旁椎间盘突出症术前和术后VAS评分之间存在统计学显著差异(p<0.05)。经椎间孔硬膜外注射类固醇治疗L4-5椎间孔旁椎间盘突出症比治疗L5-S1椎间孔旁椎间盘突出症更有效。

结论

本研究表明,在12周的随访期内,经椎间孔硬膜外注射类固醇治疗L4-5椎间孔旁椎间盘突出症比治疗L5-S1椎间孔旁椎间盘突出症更有效。

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