腰1、2、3脊神经后支+髂嵴骨纤维管道脉冲射频治疗臀上皮神经综合征的疗效分析

目的 探讨采用腰1、2、3脊神经后支+髂嵴骨纤维管道脉冲射频方法治疗臀上皮神经综合征的效果及应用价值.方法 选择臀上皮神经综合征患者30例,随机数字表法分为治疗组(腰1、2、3脊神经后支+髂嵴骨纤维管道脉冲射频治疗)和对照组(行臀上皮神经阻滞治疗).观察两组患者手术前、术后1、3、6个月视觉模拟评分法(VAS)疼痛评分和生活质量参数(日常活动干扰参数、情绪干扰参数、睡眠干扰参数),记录患者并发症的发生情况及术后1、3、6个月内患者臀腿部疼痛的复发情况.失访3例患者.结果 与术前比较,两组患者治疗后疼痛均明显缓解,差异无统计学意义(P＞0.05);术后3个月VAS评分(2.8±0.6)分比(3.3±0.4)分,术后6个月VAS评分(2.7±0.4)分比(3.7±0.5)分,治疗组显著降低(P＜0.05或0.01).1例患者在术后出现一过性的臀腿部麻木不适,48 h内缓解.患者无感染,无脊髓损伤、血管、内脏损伤等并发症发生.治疗组术后复发率小于对照组(P＜0.05或0.01).结论 腰1、2、3脊神经后支+髂嵴骨纤维管道脉冲射频术对臀上皮神经综合征的治疗安全有效,治疗后疗效持续时间长,复发率低,可以在临床治疗中推广应用.

Application of pulsed radiofrequency on L1, L2 and L3 posterior branch of spinal nerve and crista iliaca osseofibrous canal in patients with superior cutaneous gluteal nerve syndrome

Objective To study the application of pulsed radiofrequency in patients with superior cutaneous gluteal nerve syndrome and analyze its efficiency.Methods 30 patients with superior cutaneous gluteal nerve syndrome from pain department were randomized into two groups. The treatment group (reated with pulsed radiofrequency applied to L1, L2 and L3 posterior branch of spinal nerve and crista iliaca osseofibrous canal) and the control group (treated with buttock epithelial nerve block therapy). VAS scores and disturbances of the daily activity, mood and sleep were recorded before operation and after 1 day and 1,3, 6 months after treatment. Complications and recurrence within 1,3, 6 months were recorded. 3 patients were lost in follow-up.Results The VAS scores and disturbances in daily activity, mood and sleep of patients in two group were significantly decreased after surgery with no significant difference. The above indicators were significant lower compared with the control group ater 3 month (2.8±0.6) vs. (3.3±0.4) or 6 month (2.7±0.4) vs. (3.7±0.5) after treatment (P<0.05 or 0.01). One patient had tansient discomfort after surgery, which disappeared in 48 hours. All of the patients responded without complications such as infection, spinal cord and vertebral artery injury. Tlie recurrence rate after treatment was significant lower than the control group (P<0.05 or 0.01).Conclusions The treatment of pulsed radiofrequency on L1, L2 and L3 posterior branch of spinal nerve and crista iliaca osseofibrous canal has been proved to be safe and effective for the treatment of patients with superior cutaneous gluteal nerve syndrome, with longer duration of effect, lower recurrence which is worth to be extend in clinical treatment.