Pain Physician:椎间盘内注射臭氧就足以治疗LDH引起的腰腿痛,无需注射类固醇

2021-05-05 MedSci原创 MedSci原创

椎间盘内臭氧疗法是一种微创技术,用于治疗因退行性椎间盘引起的腰椎盘突出症(LDH)而对标准保守疗法无反应的患者。许多关于临床疗效的研究缺乏标准化的注射方法,并受到研究设计不足的限制。近日,一项前瞻性、

椎间盘内臭氧疗法是一种微创技术,用于治疗因退行性椎间盘引起的腰椎盘突出症(LDH)而对标准保守疗法无反应的患者。许多关于临床疗效的研究缺乏标准化的注射方法,并受到研究设计不足的限制。近日,一项前瞻性、双盲、随机对照试验探究了椎间盘周围类固醇注射与椎间盘内臭氧疗法的疗效,研究结果已发表于Pain Physician。

研究在一个三级护理中心进行,纳入了65名由LDH引起的腰腿痛患者。第一组接受椎间盘内臭氧治疗(n = 35),第二组接受椎间盘内臭氧治疗和椎间盘周围类固醇注射(n = 30)。使用视觉模拟量表(VAS)对患者进行疼痛评估,使用Oswestry残疾指数(ODI)对患者进行残疾评估,用注射前和注射后1个月和6个月的短表格36健康调查对患者的生活质量进行评估。所有手术均在无菌条件下进行。

 

结果显示,与注射前相比,两组患者在治疗后的疼痛、残疾和生活质量都有明显的改善。注射前的平均VAS在两组之间没有明显差异(VAS:第1组为7.8 ± 1.1,第2组为7.8 ± 1.2)。第一组和第二组6个月时的VAS值分别为3.6±2.4和4.1±1.6(P<0.001)。注射前的平均ODI在各组之间没有明显差异(ODI:第1组为20.9±9.6,第2组为25.2±10.3)。第一组和第二组6个月时的ODI值分别为12.8±9.2和14.3±7.2(P<0.001)。然而,各组之间没有显著差异。同样,2组之间在这些参数上也没有明显差异。

综上所述,该研究结果表明,仅靠椎间盘内注射臭氧就足以治疗LDH引起的腰腿痛,椎间盘周围注射类固醇并不能带来额外的好处。研究的局限性在于纳入的患者数量有限,随访时间有限。

 

原始出处:

 

Tulay Ercalik, Mustafa Kilic. Efficacy of Intradiscal Ozone Therapy with or without Periforaminal Steroid Injection on Lumbar Disc Herniation: A Double-Blinded Controlled Study. Pain Physician. 2020 Sep;23(5):477-484.

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