低温等离子射频消融髓核成形术治疗腰椎间盘突出症的临床效果［摘要］目的观察腰椎间盘突出症采用低温等离子射频消融髓核成形术治疗的临床疗效。方法选取2012年4〜12月北京中医药大学东直门医院东区骨伤科就诊的腰椎间盘突出症患者65例，分为治疗组33例及对照组32例。对照组采用牵引推拿，针灸配合中频、超声波物理和药物治疗，治疗组在此基础上采用低温等离子射频消融髓核成形术治疗。对两组患者的住院时间、患者满意、临床疗效，及视觉疼痛评分(VAS),腰椎功能障碍指数(ODI)评分、症状体征积分、椎间隙高度R值进行比较。结果治疗组患者住院时间［(6.83±1.52)d］少于对照组［(14.98±2.13)d］,治疗组患者满意率(92.98%)、优良率(93.94%)均高于对照组(72.41%、81.25%),差异均有统计学意义(P0.05)o结论低温等离子射频消融髓核成形术治疗腰椎间盘突出症具有创伤小、简单安全、恢复快、手术时间短、脊柱稳定性好等优点。［关键词］低温等离子射频消融髓核成形术；腰椎间盘突出症；临床疗效［中图分类号］R681.5［文献标识码］A［文章编号］1673-7210(2014)05(a)-0048-04ClinicalcurativeeffectoflowtemperatureplasmaradiofrequencynucleoplastyinthetreatmentoflumbarintervetebraldischerniationWANGZemaoMOUMingweiSUNGuoruiDepartmentofOrthopaedicsinEastDistrict,DongzhimenHospitalofBeijingUniversityofChineseMedicine,Beijing101100,China[Abstract]ObjectiveToobservetheclinicalcurativeeffectoflowtemperatureplasmaradiofrequencynucleoplastyinthetreatmentoflumbarintervetebraldischernia廿on.Methods65casesoflumbarintervetebraldischerniationfromApriltoDecember2012inDepartmentofOrthopaedicsinEastDistrictofDongzhimenHospitalofBeijingUniversityofChineseMedicinewerecollectedandrandomlydividedintothetreatmentgroupof33casesandthecontrolgroupof32cases・Thecontrolgroupwastreatedbytractionandmassage,acupuncturecombinedwithintermediatefrequency,ultrasonicphysicalanddrugtreatment,whilethetreatmentgroupwastreatedbylowtemperatureplasmaradiofrequencynucleoplastytreatmentonthebasisofthecontrolgroup.Thehospitalizationtime,satisfaction’clinicalcurativeeffect,VAS,ODIscore,symptomsandsignsscore,Rvalueofheightofintervertebralspaceofpatientsinthetwogroupswerecompared.ResultsThehospitalizationtimeofpatientsinthetreatmentgroup[(6.83±1.52)d]wassign讦icantlylessthanthatinthecontrolgroup[(14.98±2.13)d]andthesatisfactionrate(92.98%)andexcellentandgoodrate(93.94%)inthetreatmentgroupwerehigherthanthoseinthecontrolgroup(72.41%,81.25%),thedifferenceswerestatisticallysign讦icant(P0.05).ConclusionLowtemperatureplasmaradiofrequencynucleoplastyinthetreatmentoflumbarintervetebraldischerniationhastheadvantagesofsmalltrauma,simpleandsafe,quickrecovery,shortopera廿ontime,goodspinalstability・[Keywords]Lowtemperatureplasmaradiofrequencynucleoplasty;Lumbarintervetebraldischerniation;Clinicalcurativeeffect腰椎间盘突出症是临床常见病，目前对其治疗主要有手术髓核摘除、非手术、介入治疗3类方法，均可取得一定的临床疗效,3种方法各有其优缺点[1-2]o手术疗法主要采用开窗、椎板切除加髓核摘除等术式,但其手术创伤大，易发感染，恢复时间长；介入(微创)疗法因其手术创伤小，康复快而受到重视。经皮低温等离子射频消融髓核成形术治疗腰椎间盘突出症属于介入治疗方法之一，近年来越来越多的应用于临床⑶。本研究对腰椎间盘突出症采用低温等离子射频消融髓核成形术治疗的临床疗效，现报道如下：1资料与方法1.1一般资料选取2012年4〜12月北京中医药大学东直门医院东区骨伤科就诊的腰椎间盘突出症65例，其中男35例，女30例；年龄35〜70岁,平均(56.09±11.72)岁；病程7个月〜10年，平均(4.98±2.73)年。所有患者皆经临床及影像学诊断确诊。其中直腿抬高试验阳性患者48例，肌力减退63例；仰...