CAJ | 학술논문

目的探讨应用0.23 T开放性MR导引,椎间盘切割联合臭氧治疗颈椎间盘突出症的疗效.方法经MRI证实为颈椎间盘突出症的患者7例8个椎间盘,侧突型5个、旁中央型2个、中央型1个.在0.23 T开放式MR及iPath 200光学追踪系统的导引下,自健侧颈前外侧进针,避开颈动脉鞘、甲状腺、食管及椎动脉等结构,穿刺至椎间盘中心,并继续进针至椎间盘突出部分.应用椎间盘切除器切除突出部分后注射60 μg/ml O_2～O_3混合气体2 ml,然后退针至椎间盘中心髓核处,切除部分髓核组织并注入60 μg/ml O_2～O_3混合气体2 ml.术后随访:4例经电话随访、3例经门诊随访,随访时间6个月,观察患者临床症状改善情况.疗效评价采用Williams术后评价标准.结果疗效评估优5例、良1例、可1例.本组除1例术中感觉颈部一过性疼痛外,其他患者无并发症出现.结论开放性MR导引经皮颈椎间盘切割联合臭氧消融治疗颈椎间盘突出症安全、有效、创伤小.
목적 탐토응용0.23 T개방성MR도인,추간반절할연합취양치료경추간반돌출증적료효.방법 경MRI증실위경추간반돌출증적환자7례8개추간반,측돌형5개、방중앙형2개、중앙형1개.재0.23 T개방식MR급iPath 200광학추종계통적도인하,자건측경전외측진침,피개경동맥초、갑상선、식관급추동맥등결구,천자지추간반중심,병계속진침지추간반돌출부분.응용추간반절제기절제돌출부분후주사60 μg/ml O_2～O_3혼합기체2 ml,연후퇴침지추간반중심수핵처,절제부분수핵조직병주입60 μg/ml O_2～O_3혼합기체2 ml.술후수방:4례경전화수방、3례경문진수방,수방시간6개월,관찰환자림상증상개선정황.료효평개채용Williams술후평개표준.결과 료효평고우5례、량1례、가1례.본조제1례술중감각경부일과성동통외,기타환자무병발증출현.결론 개방성MR도인경피경추간반절할연합취양소융치료경추간반돌출증안전、유효、창상소.
Objective To explore the value of MR imaging-guided percutaneous cervical discectomy and discolysis with oxygen-ozone mixture for treatment of cervical disc herniation.Methods Eight herniated cervical discs in 7 patients were diagnosed by MRI, including 5 discs of lateral protruding type, 2 discs of paramedian protruding type and one disc of central protruding type.All patients underwent MR imaging-guided percutaneous cervical discectomy and discolysis with oxygen-ozone mixture.The procedures were guided by a set of 0.23 T open MR system mounted with iPath 200 optical tracking system.The herniated portion of the disc was punctured with a 14 G MR-compatible needle in the healthy side via anterolateral oblique route.The interventional steps were as follows; firstly, cut herniated part with percutaneous discectomy probe and inject 2ml oxygen-ozone mixture of 60 μg/ml; secondly, retreat the needle to the disc center, resect nucleus pulposus, and inject 2 ml oxygen-ozone mixture of 60 μg/ml.All patients were followed up for 6 months, with 4 patients by telephone and 3 patients in outpatient clinic.The effect of treatment was evaluated according to Williams postoperative assessment standard.Results All procedures were performed successfully.The clinical outcome was evaluated as excellent in 5 cases, good in 1 case and fair in 1 case.The total ratio of excellent and good was 85.7%.No serious complication occurred expect 1 case with intraoperative paroxysmal pain.Conclusion MR imaging-guided percutaneous cervical discectomy and discolysis with oxygen-ozone mixture was a safe, effective and minimally invasive method for the treatment of cervical disc herniation.