| X线引导下棘突间封闭术诊治腰椎吻合棘的初步临床疗效评价 |
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投稿时间：2013-11-07
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| 作者 | Author | 单位 | Address | E-Mail |
| 刘侃 |
LIU Kan |
中国人民解放军医学院, 北京 100853
中国人民解放军总医院第一附属医院骨科, 北京 100048 |
Orthopaedic Institute, the First Affiliated Hospital of the General Hospital of CPLA, Beijing 100048, China |
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| 吴闻文 |
WU Wen-wen |
中国人民解放军总医院第一附属医院骨科, 北京 100048 |
Orthopaedic Institute, the First Affiliated Hospital of the General Hospital of CPLA, Beijing 100048, China |
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| 郭继东 |
GUO Ji-dong |
中国人民解放军总医院第一附属医院骨科, 北京 100048 |
Orthopaedic Institute, the First Affiliated Hospital of the General Hospital of CPLA, Beijing 100048, China |
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| 任东风 |
REN Dong-feng |
中国人民解放军总医院第一附属医院骨科, 北京 100048 |
Orthopaedic Institute, the First Affiliated Hospital of the General Hospital of CPLA, Beijing 100048, China |
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| 李利 |
LI Li |
中国人民解放军总医院第一附属医院骨科, 北京 100048 |
Orthopaedic Institute, the First Affiliated Hospital of the General Hospital of CPLA, Beijing 100048, China |
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| 王华东 |
WANG Hua-dong |
中国人民解放军总医院第一附属医院骨科, 北京 100048 |
Orthopaedic Institute, the First Affiliated Hospital of the General Hospital of CPLA, Beijing 100048, China |
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| 唐家广 |
TANG Jia-guang |
中国人民解放军总医院第一附属医院骨科, 北京 100048 |
Orthopaedic Institute, the First Affiliated Hospital of the General Hospital of CPLA, Beijing 100048, China |
tangjiaguang2013@163.com |
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| 期刊信息：《中国骨伤》2014年，第27卷，第3期，第220-223页 |
| DOI：10.3969/j.issn.1003-0034.2014.03.012 |
| 基金项目:国家自然科学基金（编号：81071514） |
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中文摘要:
目的：评价在X线引导下棘突间封闭术治疗腰椎吻合棘（Baastrup病）所引起腰痛的临床疗效。
方法：2011年11月至2013年3月收治的Baastrup病患者17例，男7例，女10例；年龄40～71岁，平均为49.6岁；病史2～5年，平均3.7年。17例患者均采用X线引导下棘突间封闭术进行诊治，在术前、术后2 d、3个月及末次随访时进行疼痛视觉模拟量表（visual analogue scale，VAS）评分和测量腰椎节段活动度范围（range of motion，ROM）评价其总体手术效果，并使用改良Macnab标准进行疗效评价。
结果：所有患者获得随访，时间6～10个月，平均7.6个月。术前VAS评分为6.41±0.94，术后各时间段VAS评分均较术前明显改善（P<0.01），术后各时间段VAS评分之间差异无统计学意义（P>0.05）.术前病椎节段ROM为（4.88±0.86）°，邻近节段为（6.82±0.73）°，术后各时间段病椎节段ROM较术前有明显改善（P<0.05），邻近节段ROM较术前无明显改善（P>0.05）.按照改良Macnab标准，优6例，良7例，可3例，差1例。
结论：X线引导下棘突间封闭术是诊治Baastrup病的有效方法，其操作简单，微创、安全，能有效减轻腰背疼痛，近中期疗效明确。 |
| 【关键词】Baastrup病 棘突间注射 封闭疗法 下腰痛 |
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| Preliminary curative effect of interspinous blocking injection guiding by X-ray for the diagnosis and treatment of lumbar Baastrup’s disease |
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ABSTRACT
Objective: To evaluate the preliminary curative effect of interspinous injections for the diagnosis and treatment of back pain caused by lumbar kissing spine(Baastrup's disease) under fluoroscopically guiding.
Methods: From November 2011 to March 2013,17 patients with back pain caused by Baastrup's disease were treated with fluoroscopically-guided interspinous injections,including 7 males and 10 females with an average age of 49.6 years old ranging from 40 to 71 years old;the duration of the disease ranged from 2 to 5 years with a mean of 3.7 years. The visual analogue scale(VAS) and the lumbar segments range of motion(ROM) was analyzed at pre-operation,2 days,3 months and final followed-up after operation,the effects were evaluated with modified Macnab standard.
Results: All patients were follow-up from 6 to 10 months with an average of 7.6 months. The pre-operative VAS was 6.41±0.94,the postoperative VAS at different time points improved significantly comparing with pre-operation,and the differences were statistically significant(P<0.01). There was no significant difference in VAS at different time points after operation(P>0.05). The ROM of operated segment and adjacent segment was(4.88±0.86)° and(6.82±0.73)° respectively at pre-operation. The postoperative operated segment ROM at different time points improved significantly comparing with pre-operation,and the differences were statistically significant(P<0.05). Compared with pre-operation,there was no significant difference in adjacent segment ROM at different time points after operation(P>0.05). According to modified Macnab,the result was excellent in 6 cases,good in 7 cases,fair in 3 cases and poor in 1 case.
Conclusion: Fluoroscopically-guided interspinous injections is an effective method for the diagnosis and treatment of Baastrup's disease. The method has advantages of simple operation,minimal invasion and safety,satisfactory short-term and medium-term therapeutic effect; it can also effectively lessen the pain of lumbar and back. |
| KEY WORDS Baastrup’s disease Interspinous injection Blocking therapy Low back pain |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 刘侃,吴闻文,郭继东,任东风,李利,王华东,唐家广.X线引导下棘突间封闭术诊治腰椎吻合棘的初步临床疗效评价[J].中国骨伤,2014,27(3):220~223 |
| 英文格式: | LIU Kan,WU Wen-wen,GUO Ji-dong,REN Dong-feng,LI Li,WANG Hua-dong,TANG Jia-guang.Preliminary curative effect of interspinous blocking injection guiding by X-ray for the diagnosis and treatment of lumbar Baastrup’s disease[J].zhongguo gu shang / China J Orthop Trauma ,2014,27(3):220~223 |
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