摘要目的 观察CT引导下侧隐窝针联合针刀治疗腰椎手术失败综合征(failed back surgery syndrome,FBSS)的临床疗效。方法 将62例FBSS患者随机分为两组,每组31例,其中治疗组采用CT引导下侧隐窝针联合针刀治疗,对照组采用电针治疗。观察两组治疗前、治疗后1、3、6个月VAS和改良ODI评分。结果 两组治疗后1、3、6个月VAS和改良ODI评分逐渐降低,差异有统计学意义(P<0.05);治疗组治疗后1、3、6个月VAS和改良ODI评分较对照组降低明显,差异有统计学意义(P<0.05)。结论 CT引导下侧隐窝针联合针刀治疗FBSS疗效确切。
Abstract:Objective To observe the clinical effect of CT guided lateral recess needles combined with scalpel needle technique in the treatment of FBSS. Methods Sixty-two patients with FBSS were randomly divided into two groups, with 31 cases in each. The treatment group was treated with CT guided lateral recess needles combined with scalpel needle technique, while the control group was treated with electro acupuncture. Vas Modified ODI scores were observed before treatment, one month, three months and six months after treatment. Results The VAS and modified ODI scores of the two groups decreased gradually at 1, 3 and 6 months after treatment, especially in the treatment group, and the difference was of statistical significance (P<0.05). Conclusions CT guided lateral recess needles combined with scalpel needle technique is effective in the treatment of FBSS.
North R B, Campbell J N, James C S, et al. Failed back surgery syndrome: 5-year follow-up in 102 patients undergoing repeated operation[J]. Neurosurgery,1991,28(5):685-691.
[2]
Avellanal M, Diaz R G, Orts A, et al. One-year results of an algorithmic approach to managing failed back surgery syndrome[J]. Pain Res Manag,2014,19(6):313-316.
[3]
Harper W L, Schmidt W K, Kubat N J, et al. An open-label pilot study of pulsed electromagnetic field therapy in the treatment of failed back surgery syndrome pain[J]. Int Med Case Rep J,2015,8:13-22.
[4]
Hazard R G. Failed back surgery syndrome: surgical and nonsurgical approaches[J]. Clin Orthop Relat Res,2006,443:228-232.
Sebaaly A, Lahoud M J, Rizkallah M, et al. Etiology, evaluation, and treatment of failed back surgery syndrome[J]. Asian Spine J,2018,12(3):574-585.
[12]
Bellini M, Barbieri M. A comparison of non-endoscopic and endoscopic adhesiolysis of epidural fibrosis[J]. Anaesthesiol Intensive Ther,2016,48(4):266-271.
Sakai T, Aoki H, Hojo M, et al. Adhesiolysis and targeted steroid/local anesthetic injection during epiduroscopy alleviates pain and reduces sensory nerve dysfunction in patients with chronic sciatica[J]. J Anesth,2008,22(3):242-247.
[16]
Kallewaard J W, Vanelderen P, Richardson J, et al. Epiduroscopy for patients with lumbosacral radicular pain[J]. Pain Pract,2014,14(4):365-377.
[17]
Assaker R, Zairi F. Failed back surgery syndrome: to re-operate or not to re-operate? a retrospective review of patient selection and failures[J]. Neurochirurgie,2015,61 Suppl 1:S77-S82.
Mannion A F, Elfering A. Predictors of surgical outcome and their assessment[J]. Eur Spine J,2006,15 (Suppl 1):S93-S108.
[20]
Celestin J, Edwards R R, Jamison R N. Pretreatment psychosocial variables as predictors of outcomes following lumbar surgery and spinal cord stimulation: a systematic review and literature synthesis[J].Pain Med,2009,10(4):639-653.