Low-Dose Collagenase Chemonucleolysis Combined with Radiofrequency in the Treatment of Lumbar Disc Herniation: A 10-Year Retrospective Study.
Low-Dose Collagenase Chemonucleolysis Combined with Radiofrequency in the Treatment of Lumbar Disc Herniation: A 10-Year Retrospective Study.
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小剂量胶原酶化学溶核术联合射频治疗腰椎间盘突出症的10年回顾性研究
DOI：
10.1155/2021/8234558
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Yan Y
中科院分区：
文献类型：
--
作者：
Wang M;Zhang X;Yu Y;Xu G;Nie J;Yu B;Cao X;Qiu M;Liao Y;Zhang D;Yan Y
目的探讨小剂量胶原酶化学溶核术（CCNL）联合射频（RF）治疗腰椎间盘突出症（LDH）的10年疗效、安全性及影响预后的因素。方法收集167例腰椎间盘突出症患者的临床资料。分别采用改良MacNab标准、数字评定量表（NRS）和日本骨科协会（乔亚）评分评价患者的优良率、疼痛程度和神经功能。比较术前和术后10年患者的疼痛、麻木和肌无力。记录患者围手术期并发症、复发/再发LDH和再手术情况。最后，评估影响长期疗效的独立危险因素。结果共纳入126例患者。优良率为86.51%~ 92.86%，两组比较差异无统计学意义（P > 0.05）。术后NRS和乔亚评分明显改善（P < 0.01），术后6个月内改善最明显。术后10年，65.08%、83.95%和93.02%的患者疼痛、麻木和肌无力完全缓解（P < 0.05）。围手术期并发症3例，发生率2.38%。复发/再发LDH患者11例，占8.73%，其中9例再次手术，占7.14%。病程>12个月、责任椎间盘≥2的患者术后10年疗效可、差的概率分别是病程≤12个月、责任椎间盘= 1的患者的6.005倍和4.227倍（P < 0.05）。结论综合治疗是长期有效、安全的。病程>12个月和责任盘≥2个独立降低疗效，且病程>12个月影响更显著。
Objective This study explored the 10-year efficacy, safety, and prognostic factors of low-dose collagenase chemonucleolysis (CCNL) combined with radiofrequency (RF) in the treatment of lumbar disc herniation (LDH). Methods The data of 167 LDH patients were collected. Modified MacNab criteria, Numerical Rating Scale (NRS), and Japanese Orthopedic Association (JOA) scores were, respectively, used to evaluate patients' excellent and good rates, pain degree, and nerve function. The preoperative and 10-year postoperative patients' pain, numbness, and muscle weakness were compared. Patients' complications in perioperative period, recurrent/reappeared LDH, and reoperations were recorded. Finally, the independent risk factors affecting the long-time efficacy were assessed. Results A total of 126 patients were included. The patients' excellent and good rates were 86.51%–92.86% with no significant difference (P > 0.05). Postoperative NRS and JOA scores significantly improved (P < 0.01), most obvious within 6 months postoperatively. At 10 years postoperatively, 65.08%, 83.95%, and 93.02% of patients' pain, numbness, and muscle weakness were completely relieved (P < 0.05). Perioperative complications occurred in three patients with the rate of 2.38%. Recurrent/reappeared LDH patients were 11 with the ratio of 8.73%; nine of them underwent reoperations with the rate of 7.14%. And patients' probability of fair and poor efficacy at 10 years postoperatively with the course of disease >12 months and the responsibility disc ≥2 were, respectively, 6.005 and 4.227 times that of patients with the course of disease ≤12 months and the responsibility disc = 1 (P < 0.05). Conclusion The combined treatment is effective and safe in the long term. A course of disease >12 months and responsibility disc ≥2 independently reduce efficacy, and a course of disease >12 months has a more significant impact.
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影响因子：
7.4
作者：
Edwards, Robert R.;Klick, Brendan;Atlas, Steven J.
通讯作者：
Atlas, Steven J.
DOI：
10.4103/ajns.ajns_119_17
发表时间：
2019-07-01
期刊：
Asian journal of neurosurgery
影响因子：
--
作者：
Gelalis, Ioannis;Gkiatas, Ioannis;Korompilias, Anastasios
通讯作者：
Korompilias, Anastasios
影响因子：
--
作者：
BROCK, M;ROGGENDORF, W;CURIO, G
通讯作者：
CURIO, G
影响因子：
19.7
作者：
Dora, C;Schmid, MR;Boos, N
通讯作者：
Boos, N
影响因子：
4.1
作者：
FISHER, RG;BROMLEY, JW;MOONEY, V
通讯作者：
MOONEY, V