Reunderstand the treatment of lumbar disc herniation by chemical ablation / 局解手术学杂志

Lumbar disc herniation(LDH) is a kind of common and frequently-occurring disease which seriously affects the quality of life of patients.About 60% lumbocrural pain resulted from LDH.Chemical ablation is one of the non-vascular interventional procedures for the treatment of lumbar disc herniation in clinical minimally invasive treatment.It has many advantages such as minimally invasive,effective, low cost,and relieves or cures the pain of patients with lumbar disc herniation.This minimally invasive procedure has the interdisciplinarity characteristics with pain medicine, regional anatomy, radiography and pharmacology, which has been progressively developing from intra-lumbar intervertebral disc injection with oxidized nucleus pulposus,lumbar intervertebral disc with collagenase injection and psoas com-partment block to combined treatment.From C-arm X-ray system guided to CT and MSCT-guided which has the advantages of TLCS,precise localization,three-dimensional reconstruction,safe and rapid and guided treatment.Meanwhile,chemical ablation has serious complications, and the substance use and drug dosage have not been unified.In order to help the medic understand the development of this technology,we re-viewed chemical ablation to serve the patient better.

Misunderstanding of Foot Drop in a Patient with Charcot-Marie-Tooth Disease and Lumbar Disk Herniation

We report the case of 57-year-old woman diagnosed with Charcot-Marie-Tooth (CMT) disease and lumbar disk herniation (LDH). She had left leg weakness and foot numbness, foot deformity (muscle atrophy, high arch, and clawed toes). The lumbar spine MRI showed LDH at L4-5. Additionally, electrophysiology results were consistent with chronic peripheral motor-sensory polyneuropathy (axonopathy). In genetic testing, 17p11.2-p12 duplication/deletions characteristic of CMT disease were observed. We confirmed the patient's diagnosis as CMT disease and used conservative treatment.

CT-guided intradiscal ozone injection combined with intervertebral facet joint steroid injection for lumbar disk herniation accompanied with intervertebral arthritis / 介入放射学杂志

Objective To compare the clinical effectiveness of ozone (O_3) nucleus pulposus ablation only with that of 03 nucleus pulposus ablation combined with intervertebral facet joint injection of compound Betamethasome in treating lumbar disk herniation accompanied with intervertebral facet arthritis. Methods Eighty patients with lumbar disk herniation and intervertebral facet arthritis were equally and randomly divided into two groups. Under CT guidance, O_3 nucleus pulposus ablation was performed in patients of group A(n = 40), while O_3 nucleus pulposus ablation combined with intervertebral facet joint injection of compound Betamethasome (0.5 ～ 1 ml) was carried out in patients of group B (n = 40). Using double blind method the therapeutic effectiveness was evaluated before and 1 week, 3, 6-months after the procedure by an Oswestry Low Back Pain Disability Questionnaire. Results One week after the procedure the effective rate of group A and group B was 65% and 82.5% respectively. Three and six months after the treatment, the effective rate was 75% and 70% respectively for group A, while it was 90% and 92.5% respectively for group B. The difference between two groups was significant (P < 0.05). Conclusion lntradiscal injection of O_3 combined with intervertebral facet joint injection of compound Betamethasome is an effective and safe treatment for lumbar disk herniation accompanied with intervertebral facet arthritis. It is worth popularizing this technique in clinical practice.