CAJ | 학술논문

目的：探讨骶尾间隙注射治疗腰椎术后综合征的临床效果。方法：1998年7月至2012年10月收治腰椎术后综合征患者47例，男39例，女8例；年龄35～89岁，平均61．5岁。其中经历1次手术患者41例，2次手术患者6例。41例行单、双侧开窗或中央椎板开窗减压，间盘切除；6例行全椎板切除减压间盘切除椎弓根钉固定椎间融合。治疗前均行X线、CT或MRI检查。治疗前停用抗凝药物，俯卧位骶尾间隙进针，遇落空感，回吸无血液及脑脊液，注入脉络宁复合液。治疗前后采用VAS评分系统进行疼痛度评定，同时行Oswestry腰痛失能指数和生存质量受干扰程度评分。结果：治疗后1个月，VAS评分由治疗前的59．24±17．35，降低至19．19±11．19；Oswestry腰痛失能指数由治疗前的（41．35±9．87）％，降低至（23．17±17．56）％；生存质量受干扰程度由治疗前的（6．5±2．2）分，降低至（2．6±1．4）分，治疗前后差异均有统计学意义（P＜0．05）。结论：骶尾间隙注射治疗腰椎术后综合征具有操作简单、安全、并发症少、治疗费用低的优点。
목적：탐토저미간극주사치료요추술후종합정적림상효과。방법：1998년7월지2012년10월수치요추술후종합정환자47례，남39례，녀8례；년령35～89세，평균61．5세。기중경력1차수술환자41례，2차수술환자6례。41례행단、쌍측개창혹중앙추판개창감압，간반절제；6례행전추판절제감압간반절제추궁근정고정추간융합。치료전균행X선、CT혹MRI검사。치료전정용항응약물，부와위저미간극진침，우락공감，회흡무혈액급뇌척액，주입맥락저복합액。치료전후채용VAS평분계통진행동통도평정，동시행Oswestry요통실능지수화생존질량수간우정도평분。결과：치료후1개월，VAS평분유치료전적59．24±17．35，강저지19．19±11．19；Oswestry요통실능지수유치료전적（41．35±9．87）％，강저지（23．17±17．56）％；생존질량수간우정도유치료전적（6．5±2．2）분，강저지（2．6±1．4）분，치료전후차이균유통계학의의（P＜0．05）。결론：저미간극주사치료요추술후종합정구유조작간단、안전、병발증소、치료비용저적우점。
Objective:To explore the clinical effect of the sacrococcygeal space injection for the treatment of failed back surgery syndrome. Methods:From July 1998 to October 2012,47 patients with failed back surgery syndrome were treated and included 39 males and 8 females with an average age of 61.5 years old ranging from 35 to 89 years old. Among them ,41 pa-tients experienced one time of operation,6 patients with twice of operation. Forty one patients underwent single,bilateral fen-estration or central laminectomy decompression ,discectomy. Six patients underwent total laminectomy discectomy and inter body fusion and pedicle screw fixation. All patients were examined by X ray plain film,CT or MRI before treatment. The anti-coagulation was discontinuation before treatment. The needle was put into the sacrococcygeal gap at prone position in the sense of frustration,suction without cerebrospinal fluid and blood,with injection of Mailuoning (脉络宁) 15 ml. The pain was as-sessed by VAS before and after treatment. The Oswestry low back pain disability index and survival quality interference degree were evaluated. Results:At 1 month after treatment,the pain VAS decreased from 59.24 ±17.35 before treatment to 19.19 ± 11.19 after treatment(P<0.05);The Oswestry low back pain disability index decreased from (41.35±9.87)%before treatment to (23.17±17.56)%after treatment (P<0.05);The survival quality interference degree decreased from 6.5±2.2 before treat-ment to 2.6±1.4 after treatment (P<0.05). Conclusion:The sacrococcygeal gap injection for treatment of failed back surgery syndrome has advantages of simple,safe,fewer complications,and low treatment cost.