摘要
目的:介绍运用DSA引导下行选择性神经根造影与阻滞,治疗顽固性神经根型颈椎病,并评估临床疗效、并发症。方法:32例顽固性神经根型颈椎病患者,在三维DSA类CT重建引导下经椎间孔穿刺行选择性神经根造影成功后,注入利多卡因与得宝松混合镇痛液。分别测定患者治疗前、治疗后3d、1月、6月、12月、24月视觉模拟评分(VAS),同时按照改良MacNab评估临床疗效。结果:32例治疗前VAS评分平均值为(8.31士0.78)分,治疗后3d、1月、6月、12月及24月VAS评分分别为:(1.28±1.51)分、(1.34±1.07)分、(1.53±1.27)分、(1.75±1.65)分、(2.13±1.72)分,治疗后与治疗前比较,差异有统计学意义(P<0.01),治疗后改良Macnab疗效评价,优良率分别96.9%、93.8%、93.8%、90.6%、87.5%。治疗后有一过性手指及上肢麻木、沉重感,数小时后自然缓解,无其他并发症发生。结论:DSA引导下行选择性神经根造影与阻滞治疗顽固性神经根型颈椎病高效、简单、经济、安全,值得临床推广。
Objective：To evaluate the clinical efficacy and complications of digital subtraction angiography （DSA）- guided selective cervical nerve root radiculography and blocking for the treatment of refractory cervical spondylotic radiculopathy. Methods：Thirty-two patients of the refractory cervical spondylotic radiculopathy were injected xylocaine and diprospan after DSA-guided selective cervical nerves root radiculography. Pain visual analogue scale （VAS） scores before treatment and 3days, 1, 3, 6, 12, and 24 months after treatment as well as the improved MacNab were used to assess the curative effect. Results：The average value of VAS score was 8.31 ：[： 0.78 before treatment, which were respectively 1.28 ：：[： 1.51, 1.34 ：J：： 1.07, 1.53 -]： 1.27, 1.75 -k： 1.65, and 2.13 ：J： 1.72 3days, 1, 3, 6, 12, and 24 months after the treatment. There was significant difference between preoperative and postoperative results （P〈0.05）. The rate of fineness by improved MacNab was 96.9%, 93.8%, 93.8%, 90.6%, and 87.5%, respectively. The patients felt transient acroanesthesia and heaviness in fingers and upper extremities, which was relieved a few hours later naturally. There was no other complication ob- served. Conelusion：DSA-guided selective cervical nerves root radiculography and blocking for the treatment of refractory cervical spondylotic radiculopathy has high accuracy, easiness, safety and economy, so it is worthy of clinical application and generalization.
出处
《中国中医骨伤科杂志》
CAS
2014年第8期18-20,共3页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
关键词
神经
造影
阻滞
神经根型颈椎病
Nerve
Radiculography
Blocking
Cervical spondylotic radiculopathy
