CAJ | 학술논문

目的评价经皮椎间盘内臭氧注射治疗腰椎间盘突出症的长期疗效. 方法回顾性分析南方医科大学珠江医院影像中心及南方医院介入治疗科自2002年7月至2004年3月应用臭氧治疗的324例腰椎间盘突出症患者的临床资料.所有患者均随访≥3年,比较术前和最后随访时日本骨科学会(JOA)评分及下肢根性痛的视觉模拟评分(VAS);运用改良的MacNab分级法记录最后随访的临床效果并评价患者年龄、病史长短、突出程度及类型等因素对治疗效果的影响. 结果本组患者JOA评分、下肢根性痛VAS术前及术后终末随访时比较差异均有统计学意义(6.3±1.4 vs 13.1±1.2,P=0.018;7.5±0.8 vs 2.1±0.3,P=0.039),JOA评分、VAS改善率分别为78.2%和70.4%;改良的MacNab分级法记录到最后随访时疗效优良率为77.5%(251/324),患者年龄、病程及椎间盘突出程度对疗效有明显影响;部分(33.8%)包含型突出患者治疗后近期可有症状"反跳".结论臭氧治疗腰椎间盘突出症术后3年以上随访结果显示疗效令人满意,患者年龄、病程和椎间盘突出程度能影响患者疗效.
목적 평개경피추간반내취양주사치료요추간반돌출증적장기료효. 방법회고성분석남방의과대학주강의원영상중심급남방의원개입치료과자2002년7월지2004년3월응용취양치료적324례요추간반돌출증환자적림상자료.소유환자균수방≥3년,비교술전화최후수방시일본골과학회(JOA)평분급하지근성통적시각모의평분(VAS);운용개량적MacNab분급법기록최후수방적림상효과병평개환자년령、병사장단、돌출정도급류형등인소대치료효과적영향. 결과본조환자JOA평분、하지근성통VAS술전급술후종말수방시비교차이균유통계학의의(6.3±1.4 vs 13.1±1.2,P=0.018;7.5±0.8 vs 2.1±0.3,P=0.039),JOA평분、VAS개선솔분별위78.2%화70.4%;개량적MacNab분급법기록도최후수방시료효우량솔위77.5%(251/324),환자년령、병정급추간반돌출정도대료효유명현영향;부분(33.8%)포함형돌출환자치료후근기가유증상"반도".결론 취양치료요추간반돌출증술후3년이상수방결과현시료효령인만의,환자년령、병정화추간반돌출정도능영향환자료효.
Objective To evaluate the leng-term effect ofpercutaneous ozone injection into the intervertebral space for treatment of lumbar disc herniation. Methods A retrospective analysis of the clinical data was performed in 324 patients with lumbar disc herniation admitted in Zhujiang Hospital and Nanfang Hospital, Southern Medical University between April, 2000 and March, 2004. All the patients were treated with percutaneous ozone injection into the intervertebral space and followed up for no less than 3 years. The scores of the Japanese Orthopedics Association (JOA) and sciatica Visual Analog Scales (VAS) before and at the end of the follow-up were recorded and compared. The modified MacNab criteria were adopted for evaluation of the effect of the treatment. The patients' age, disease course, severity of disc herniation and type of herniation were also analyzed in relation to the therapeutic effect. Results Compared with the scores recorded before the operation, the average scores of JOA and VAS increased significantly at the end of the follow-up (6.3±1.4 vs 13.1±1.2 for JOA, P=0.0178;7.5±0.8 vs 2.1±0.3 for VAS, P=0.039), with JOA and VAS improvement rates of 78.2% and 70.4%, respectively. According to modified MacNab criteria, good therapeutic effect was achieved in 77.5% (251/234) of the cases, the patients' age, the disease course and severity of disc herniation showed significant impact on the therapeutic effect. More than one third of the patients (33.8%) with herniation of inclusion type experienced symptom relapse early after the treatment. Conclusion The 3-year follow-up data show that ozone treatment produces satisfactory long-term effect on lumbar disc herniation. The patient's age, disease course and severity of herniation are three important factors that affect the long-term therapeutic effect.