摘要
目的探讨超声引导L_(3)-L_(4)胸腰筋膜中层注射治疗腰椎手术后疼痛综合征(failed back surgery syndrome,FBSS)的疗效分析。方法选择2018年8月~2020年8月本院收治的100例FBSS患者,采用随机数字表法分为两组:对照组给予超声引导脊神经后内侧支注射治疗,观察组采用超声引导L_(3)-L_(4)胸腰筋膜中层注射治疗。比较两组患者治疗前、治疗后1 h、3个月时的VAS评分以及Oswestry功能障碍指数(Oswestry disability index,ODI),治疗后3个月时采用MacNab疗效标准评估综合疗效。结果两组治疗后1 h、3个月时的ODI指数以及VAS评分较治疗前均显著降低(P<0.05),且观察组治疗后1 h、3个月时的两项指标评分均显著低于对照组(P<0.05);治疗后3个月时,观察组的优良率显著高于对照组,差异有统计学意义(P<0.05)。结论相较于传统脊神经后内侧支注射,超声引导L_(3)-L_(4)胸腰筋膜中层注射在缓解腰部疼痛及功能障碍方面效果更佳,有望成为FBSS注射治疗的新靶点。
Objective To investigate the efficacy of ultrasound-guided L_(3)-L_(4)thoracolumbar fascia injection in the treatment of failed back surgery syndrome(FBSS).Methods A total 100 FBSS patients in our hospital from August 2018 to August 2020 were selected in this study and randomly divided into two groups.The control group was given ultrasound-guided injection of posterior medial branch of spinal nerve,and the observation group was given ultrasound-guided injection of L_(3)-L_(4)thoracolumbar fascia.Visual analogue scale(VAS)and Oswestry disability index(ODI)were compared before treatment,1 h and 3 months after treatment.Macnab standard was used to evaluate the comprehensive efficacy after 3 months of treatment.Results The ODI index and VAS score of the two groups at 1 h and 3 months after treatment were significantly lower than before treatment,and these two indicators of the observation group at 1 h and 3 months after treatment were significantly lower than those of the control group,with statistically significant differences(P<0.05).After 3 months of treatment,the excellent and good rate of the observation group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with the traditional posterior medial branch of spinal nerve injection,ultrasound-guided L_(3)-L_(4)thoracolumbar fascia injection has better effect in relieving lumbar pain and dysfunction,which is expected to become a new target for FBSS injection therapy.
作者
王艺晓
唐晓恒
王国梁
王莉
WANG Yi-xiao;TANG Xiao-heng;WANG Guo-Liang;WANG Li(Department of Ultrasound Medicine,the Second Affiliated Hospital of Air Force Medical University,Xi’an,Shaanxi 710038,China)
出处
《颈腰痛杂志》
2021年第5期617-619,共3页
The Journal of Cervicodynia and Lumbodynia
基金
国家自然科学基金(编号:81701718)。
