腰椎硬脊膜外神經整形手術用於治療椎間盤突出引起之疼痛治療後一年成效追蹤

Outcomes of Epidural Neuroplasty to Treat Lumbar Discogenic Pain- One-Year Follow-Up

腰椎硬脊膜外神經整形手術（Epidural neuroplasty）屬於一種脊椎第侵入性的微創手術，用來解決椎間盤突出引起的下背痛及下肢疼痛，特別是針對一些保守性治療無效的病患，仍有疼痛的情況符合接受此項治療。已經有部分的研究針對治療本身的有效程度，功能性的維持，以及疼痛藥物的給予劑量，呈現確定上述微創手術的療效。本篇文章主要是討論用上述方式治療椎間盤突出引起的下背痛及雙下肢一年成效的追蹤研究。方法：本實驗的目的在於評估長期因為椎間盤突出所引起的下背痛或者是單節神經遭受椎間盤壓迫所引起的下肢坐骨神經痛，接受腰椎硬脊膜外神經整形手術後一年治療。結果的追蹤研究，我們回溯性，非隨機性地蒐集了26位病患，分別在接受治療前以及治療後3個月，6個月，12個月接受評估。評估的方式使用自覺疼痛評估指數VA8（visual analog scale），使用止痛藥物的劑量以及生活品質失能評估指數ODI（Oswestry Disability Index）與手術前的比較做分析研究。結果：本研究比較接受治療前及3個月後，病患在疼痛及藥物的使用上都呈現明顯而有意義的減少，而在生活功能狀況評估上也發現治療後3個月時有明顯的進步。全部接受治療的病患，皆沒有因為這項微創手術引起併發症及後遺症。

Epidural neuroplasty have emerged as minimally invasivetechniques for treatment of low back pain and lower extremity pain due tocontained herniated discs when conservative management has failed. A few studieshave examined their effects on functional activity and pain medication use.Outcomes of the procedure to treat the ailment were not analyzed over time.Methods The aim of our study was to evaluate the outcome of epiduralneuroplasty in patients with chronic discogenic pain or sciatica due to nerve rootcompression by a single-level, contained herniated disc. Patients were assessedbefore and 3, 6, and 12 months after treatment by a blinded investigator. In ourretrospective, non-randomized case series, 26 patients with therapy of epiduralneuroplasty were included. Patients were evaluated at 3, 6, and 12 monthspostoperatively, and were asked to quantify their pain using a visual analog scale.Patients were also surveyed in regards to their pain medication use, and OswestryDisability Index (ODI) was quantified by third-party observers. Data at 3, 6, and12 months posttreatment were compared to baseline.Results There was a significant decrease in pain and medication use reportedin first three months after the treatment. Functional status also improved at the first3 months. There were no complications associated with the procedure.Conclusion Epidural neuroplasty appear to be safe and significantly effectivein either early post-treatment periods. Randomized, controlled studies are nowrequired to further evaluate long-term efficacy of the combination therapy.