经骶裂孔接触性溶解术治疗游离型腰椎间盘突出症
河南省洛阳正骨医院 (河南省骨科医院), 介入科, 河南洛阳 471000
| 摘 要： | 目的 探索经骶裂孔接触性溶解术（Contactive Chemonucleolysis Through Sacral Hiatus, CCTSH）治疗游离型腰椎间盘突出症的安全性及疗效。方法 设计前瞻性随机对照临床试验，按照纳入标准，研究组20例，采用CCTSH，对照组20例，采用经骶裂孔化学溶解术。记录造影剂过敏，马尾损伤，穿刺点感染，化学性脑脊髓膜炎等相关并发症。比较术前、术后24h及术后72h的疼痛指标（VAS）；比较术前、术后3天（d）、术后3个月（m）的脊柱功能障碍指数（ODI）；比较术前、术后3 m CT/MRI影像，评价游离组织大小变化。结果 两组共40例患者，均顺利完成手术，无严重并发症，对照组后期失访1例。治疗前、治疗后24 h及72 h，两组患者的VAS评分均呈现下降趋势，评分差异有统计学意义（P<0.05）；治疗前、治疗后24 h组间比较无差别（P>0.05），治疗后72 h组间比较有显著差别（P<0.05）；治疗前、治疗后3 d及3 m，两组患者ODI逐渐下降，差异有统计学意义（P<0.05）；治疗前组间比较无差别（P>0.05），治疗后组间比较有显著差别（P<0.05）；术前、术后3个月两组患者CT/MRI影像显示，游离组织均明显变小，差异有统计学意义（P<0.05）；治疗前组间比较无差别（P>0.05），治疗后组间比较有显著差别（P<0.05）。结论 CCTSH治疗游离型腰椎间盘突出症是一种安全的有效的微创方法，优于传统经骶裂孔化学溶解术。 |
| 关 键 词： | 接触性溶解术; 介入治疗; 腰椎间盘突出症 |
| DOI： | 10.57237/j.cmf.2026.02.001 |
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收稿日期: 2026-05-21
接受日期: 2026-06-16
在线出版日期: 2026-07-07
Contactive Chemonucleolysis Through Sacral Hiatus in Treatment of Free Lumbar Disc Herniation
Department of Interventional Surgery, Luoyang Orthopedic-Traumatological Hospital of Henan Province, Luoyang 471000, China
| Abstract: | Objective: To evaluate the safety and efficacy of Contactive chemolysis through sacral hiatus (CCTSH) in the treatment of free lumbar disc herniation. Methods: A prospective randomized controlled clinical trial was designed. According to the inclusion criteria, 20 patients in the study group were treated with CCTSH, and 20 patients in the control group were treated with Chemical lysis through the sacral hiatus. The complications such as puncture site infection, chemical cerebrospinal meningitis, cauda equina injury, contrast medium allergy and so on were recorded. The pain index (VAS) was compared before operation, 24 hours and 72 hours after operation, The spinal dysfunction index (ODI) was compared before operation, 3 days and 3 months after operation, and the size of prolapse was compared on CT/MRI before operation and 3 months after operation. Results: All the 40 patients in the two groups were successfully operated without serious complications, and one patient in the control group was lost to follow-up. The VAS scores of the two groups showed a downward trend before treatment, 24 h and 72 h after treatment, and the difference was statistically significant (P < 0.05); there was no difference between the two groups before treatment, 24 h after treatment (P > 0.05), and there was a significant difference between the two groups 72 h after treatment (P < 0.05); Before treatment, 3 days and 3 months after treatment, the ODI of the two groups decreased gradually, and the difference was statistically significant (P < 0.05), There was no difference between the two groups before treatment (P > 0.05), but there was significant difference between the two groups after treatment (P < 0.05); the prolapse in CT/MRI images of the two groups before and 3 months after the operation was significantly smaller, and the difference was statistically significant (P < 0.05), There was no difference between the two groups before the treatment (P > 0.05), but there was significant difference between the two groups after the treatment (P < 0.05). Conclusion: CCTSH is a safe, effective and minimally invasive method for the treatment of free lumbar disc herniation. |
| Keywords: | CCTSH; Interventional Therapy; LDH |
基金
| 1. | 2023河南省医学科技攻关计划 (LHGJ20230485) |
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