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BACKGROUND:CT-guided percutaneous intervention and rehabilitation techniques are both classic programs for diagnosis and treatment of lumbar disc herniation. Is the combination of CT-guided percutaneous intervention and rehabilitation techniques preferential y used for treatment of lumbar disc herniation? OBJECTIVE:To evaluate the curative effect of CT-guided interventional injection combined with rehabilitation integration treatment for lumbar disc herniation and to analyze prognostic factors. METHODS:Eighty-eight patients with lumbar disc herniation were subjected to CT-guided interventional injection combined with rehabilitation integration treatment from May 2010 to May 2013. Injection medicine consisted of betamethasone, tanshinone Ⅱ A sulfonate, neurotropin, normal saline and iohexol. Rehabilitation integration treatment included traction, manipulation, acupuncture, transcutaneous electrical nerve stimulation and thermal magnon. Macnab criteria and Chinese version of Oswestry low back pain disability questionnaire were used to assess the curative effects in comparison with the 112 patients receiving only CT-guided interventional injection that were reported previously. The prognostic factors, such as age, disease course time and herniation type of target segment were testified by correlation analysis. RESULTS AND CONCLUSION:Total y 77 patients were completely fol owed up for 1 year. There were excellent outcomes in 64 cases, while favorable outcomes in 7 cases, fair outcomes in 5 case, poor outcome in 1 case, with a better outcome rate of 92%.There was a significantly decreased trend in Oswestry disability Index scores at 1, 6, 12 months during the fol ow-ups (P0.05). The young group (≤ 45 years) had better outcomes than the older group (>45 years;P0.05). These findings indicate that CT-guided interventional injection combined with rehabilitation integration treatment could relieve lower back pain and radical leg pain effectively and decrease life disability level.
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Objective To evaluate the clinical effect of lumbar intervertebral disc herniation (LIDH) by CT-guided precise injection around nerve root and in epidural cavity. Methods One hundred and eight patients of LIDH were treated by CT-guided precise injection around nerve root and in epidural cavity, and followed-up after 1, 3 and 6 months. Visual analogue score (VAS) for pain was used to evaluate the efficacy before and after treatment. Results In 108 cases, there were 83 patients (76.9%) with good result whose improvement of VAS was greater than or equal 50% after treatment 1, 3 and 6 months. There were 19 patients (17.6%) with fair result whose improvement of VAS was less than 50% after treatment 1, 3 and 6 months. There were 6 patients (5.6%) with invalid result whose improvement of VAS was unobvious after treatment 1, 3 and 6 months. Conclusion CT-guided therapy of LIDH by precise injection around nerve root and in epidural cavity is safe, accurate, effective, minimally aggressive technique and worth being practiced clinically.
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Objective To identify the short and long-term therapeutic benefits of CT-guided transforaminal epidural steroid injections in lumbar spinal stenosis. Methods Thirty six patients with lumbar spinal stenosis shown by CT underwent CT-guided transforaminal epidural steroid injections because of irresponsible to conservative treatment. Patients were evaluated by visual analogue scale (VAS) before the initial injection, at 2 weeks and 1 year after the injection.Results All patients were followed up for 2 weeks and 1 year. 19 ( 52.8%) patients had successful short-term outcome, and 15 ( 41.6%) had long-term outcome. 15 ( 41.6%) patients satisfied with the short-term result and 12 (33.3%) were satisfactory with the long-term result.Conclusions CT-guided transforaminal epidural steroid injection may reduce the pain and improve the quality of life in some patients with lumbar spinal stenosis.
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Objective To evaluate the efficacy of percutaneous CT-guided puncture and steroid injection for the treatment of lumbar intraspinal synovial cysts (LISCs).Methods A patient with clinical symptom of LISCs was undergone percutaneous CT-guided lumbar synovial cyst puncture. After aspiration of the content and steroid injection were accomplished, visual analogue scale was used to evaluate the pain of the patient before and after the treatment.Results Excellent pain relief after aspiration and steroid injection was obtained with the symptom disappearing 4 days after the treatment.Conclusions Aspiration and steroid injection can reduce the pain of the patient with lumbar intraspinal synovial cysts,and it should be the frist choice of non-surgical treatment.