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穿刺切吸加胶原酶间盘内溶核术治疗颈椎间盘突出症临床观察
Objective To evaluate the efficacy of a treatment modality for cervical intervertebral disc herniation which consisted of aspiration of nucleus pulposus tissue in conjunction with nucleolysis by intravertebral disc injection of collagenase. Method From June 1997 to June 2000,we excuted aspiration of intervertebral disc content followed by collagenase injection that resulted in chemical neclolysis of the remainder of the nucleus pulplsus tissue in 52 patients with 94 herniated intervertebral discs.Around 600 u(1 ml) of collagenase per intervertebral disc was used.The success with this treatment was judged by clinical observation and imaging means.Results Follow up study ranging from 6 months to 24 months revealed excellent and good results in 90% of all patients with any complications.Preoperative and postoperative lateral X ray films of the cervical spine in hyperextension and hyperflexion were taken which showed no remarkable alterations in the stability status.Conclusions Aspiration plus nucleolysis by means of intraintervertebral disc collagenase is safe and effective for some patients with cervical intervertebral disc herniation.
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在椎间盘突出物或椎间盘内注射胶原酶对椎间盘突出症治疗作用的研究
Objective To compare effect of chemonucleolysis of collagenase injected intraprotrusion(disc protrusion) with intradisk (disc centre ) at the affected disc guided by computer scan(CT) on lumbar disc herniation. Method 156 patients were randomly divided into two groups.Repeat CT shows guided 1200 U collagenase intraprotrusion or intradisk injection of the affected disc via extradural or intradual way for the patients.3 month follow up was performed to evaluate the therapeutic effect.Result The observation indicated that the patients showed no any seriously side effect.The effective rate was 86% for intraprotrusion injection and 71% for intradisk injection respectively.χ 2 test demonstrated the difference was significant(χ 2=5.3969).Conclusion Guided under CT, intraprotrusion injection with collagenase at the affected disc is safe,more effective treatment than that of intradisk injections for lumbar disc herniation.
