摘要
目的评估背根神经节阻滞联合脉冲射频治疗腰椎术后根性疼痛的短期疗效及安全性。方法回顾性分析2017年1月~2019年12月103例因腰椎术后根性疼痛住院接受腰椎背根神经节阻滞联合脉冲射频治疗的资料,比较术前和术后1、3和6个月疼痛数字评价量表(Numerical Rating Scale,NRS)评分、Oswestry功能障碍指数(Oswestry Disability Index,ODI),改良MacNab标准评价疗效,并进一步分析可能影响术后疗效的因素。结果手术均顺利完成,无神经根损伤、脑脊液漏、感染等严重并发症。术后各时间点NRS评分、ODI均较术前降低(P<0.05);与术后1、3个月相比,术后6个月NRS评分和ODI升高(P<0.05)。术后6个月改良MacNab标准结果为优25例,良36例,可28例,差14例,优良率59.2%(61/103)。疗效差(包括可和差)组合并焦虑抑郁的患者比例[64.3%(27/42)]显著高于疗效好(包括优和良)组[44.3%(27/61)](P=0.046)。结论背根神经节阻滞联合脉冲射频治疗可降低腰椎术后根性疼痛病人下肢疼痛程度,改善功能障碍程度,总体短期疗效较好,安全性好,临床疗效可能受焦虑抑郁等不良情绪影响。
Objective To investigate the short-term clinical efficacy and safety of dorsal root ganglion block(DRGB)combined with dorsal root ganglion pulsed radiofrequency(DRG-PRF)in the treatment of lasting radicular pain after lumbar surgery.Methods A retrospective analysis was conducted on medical data of 103 patients admitted for lasting radicular pain after lumbar surgery and received DRGB combined with DRG-PRF from January 2017 to December 2019.The score of Numeric Rating Scale(NRS),Oswestry Disability Index(ODI)and modified MacNab criteria were compared at different time points.The factors affecting postoperative outcomes were analyzed.Results All the procedures were performed successfully with no obvious adverse complications such as nerve root injury,cerebrospinal fluid leakage or infection.Compared with pre-operation,both NRS score and ODI were decreased significantly at all time points(1-month,3-month and 6-month)after surgery(P<0.05).Compared with 1 month and 3 months after surgery,both NRS score and ODI were increased significantly at 6 months after surgery(P<0.05).The result of modified MacNab criteria 6 months after operation revealed the following:excellent in 25 cases,good in 36 cases,fair in 28 cases and poor in 14 cases,the good quality rate being 59.2%(61/103).Anxiety and depression were significantly more prevalent in effect group than poor effect group[64.3%(27/42)vs.44.3%(27/61),P=0.046].Conclusion DRGB combined with DRG-PRF relieves pain,improves daily dysfunction and has a good short-term clinical efficacy and high safety in patients with lasting radicular pain after lumbar surgery,but the curative effect may be affected by factors like anxiety and depression.
作者
李水清
易端
贾东林
刘晓光
Li Shuiqing;Yi Duan;Jia Donglin(Pain Medicine Department, Peking University Third Hospital, Beijing 100191, China)
出处
《中国微创外科杂志》
CSCD
北大核心
2020年第11期977-981,共5页
Chinese Journal of Minimally Invasive Surgery
基金
中央保健科研课题基金(W2017BJ53)。
关键词
腰椎手术
根性疼痛
背根神经节
脉冲射频
Lumbar surgery
Radicular pain
Dorsal root ganglion
Pulsed radiofrequency
