Budrovac Dino, Pavošević Marko, Radoš Ivan, Hnatešen Dijana, Tot Ozana Katarina, Haršanji-Drenjančević Ivana, Venžera Azenić Darija, Kristić Marica, Omrčen Ivan, Petričević Anja
Department of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Centre Osijek, Croatia.
Josip Juraj Strossmayer University Osijek, School of Medicine, Department of Anesthesiology, Reanimatology and Intensive Care, Osijek, Croatia.
Acta Clin Croat. 2023 Nov;62(Suppl4):12-18. doi: 10.20471/acc.2023.62.s4.2.
Lumbar radicular pain is a major public health, social and economic problem and is often the cause of professional disability. The aim of this study was to compare pain intensity, disability and neuropatic pain depending on the method of treatment (epidural steroid injection or percutaneous laser disc decompression) in the treatment of lumbar radicular pain caused by intervertebral disc herniation with or without discoradicular contact. Data were collected from 28 patients at 3 measurement points (before the procedure and at examinations on the 15th and 30th day after the procedure) using the Numeric Rating Scale (NRS), Oswestry Disabilitiy Indeks (ODI) and Pain Detect. The reduction of the pain after the procedure was statistically significant only in the group of patients with discoradicular contact in whom PLDD was performed (P=0.04). From the obtained results, it can be concluded that percutaneous laser disc decompression (PLDD) led to a greater reduction in disability (P=0.009) in patients with discorradicular contact, whereas lumbar transforaminal epidural steroid injection (ESI TF) led to greater reduction in patients without discorradicular contact (P=0.02). The results indicate that there was a significant (P=0.01) reduction in neuropathic pain in patients without discorradicular contact who were treated with ESI TF and in patients with discoradicular contact who were treated with PLDD (P=0.04).
腰椎神经根性疼痛是一个重大的公共卫生、社会和经济问题，常常是职业残疾的原因。本研究的目的是比较在治疗伴有或不伴有椎间盘神经根接触的椎间盘突出症所致腰椎神经根性疼痛时，根据治疗方法（硬膜外类固醇注射或经皮激光椎间盘减压术）的不同，疼痛强度、残疾程度和神经性疼痛的差异。使用数字评分量表（NRS）、Oswestry残疾指数（ODI）和疼痛检测量表，在3个测量点（术前以及术后第15天和第30天检查时）收集了28例患者的数据。术后疼痛减轻仅在接受经皮激光椎间盘减压术的伴有椎间盘神经根接触的患者组中具有统计学意义（P = 0.04）。从所得结果可以得出结论，经皮激光椎间盘减压术（PLDD）使伴有椎间盘神经根接触的患者残疾程度降低更明显（P = 0.009），而腰椎经椎间孔硬膜外类固醇注射（ESI TF）使不伴有椎间盘神经根接触的患者残疾程度降低更明显（P = 0.02）。结果表明，接受ESI TF治疗的不伴有椎间盘神经根接触的患者以及接受PLDD治疗的伴有椎间盘神经根接触的患者神经性疼痛均有显著减轻（P = 0.01）（接受PLDD治疗的患者P = 0.04）。
