Clinical study of targeted epidural space block combined with acupotomy in the treatment of lumbar disc herniation under X-ray guidance
10.3969/j.issn.1672-8270.2025.03.013
- VernacularTitle:X射线引导下硬膜外靶向阻滞联合针刀治疗腰椎间盘突出症研究
- Author:
Yingzheng ZHANG
1
;
Yadong WANG
;
Xiaoyue DENG
;
Lu CAI
;
Weizhen WANG
;
Qiuxia YANG
;
Yafang SUN
;
Feifei LIU
Author Information
1. 南京中医药大学江阴附属医院疼痛科 江阴 214400
- Publication Type:Journal Article
- Keywords:
Lumbar disc herniation;
Anterior epidural space targeted block;
Acupotomy;
X-ray guidance;
Safety analysis
- From:
China Medical Equipment
2025;22(3):68-72
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical efficacy of targeted epidural space block combined with acupotomy in the treatment for lumbar disc herniation(LDH)under the monitor of X-ray image,and to analyze the safety of its operation.Methods:A total of 60 LDH patients who admitted to Department of Pain,Jiangyin Affiliated Hospital of Nanjing University of Chinese Medicine from January 2022 to September 2023 were selected,and they were randomly divided into observation group and control group as random number table,with 30 cases in each group.The observation group adopted targeted epidural space block combined with acupotomy under monitor with X-ray for anterior epidural space,while the control group adopted conventionally epidural block,all of which were treated only once.The Visual Analogue Scale(VAS)scores and Oswestry Disability Index(ODI)scores of two groups before treatment and at the 3rd day,7th day and 30th day after treatment were compared.At the 30th day after treatment,the curative effects of two groups were evaluated according to ODI scores,at the same time,the safe distance between puncture and acupotomy in patients of observation group was analyzed.Results:The effective rates of the treatment of observation group and control group were respectively 96.67%and 70%,and the difference of that between the two groups was statistically significant(x2=7.680,P<0.05).The VAS scores of the two groups at the 3rd day,7th day and 30th day after treatment were lower than those before treatment,and the observation group(2.30±0.87),(1.53±0.86)and(1.47±0.81)were lower than the control group(4.43±0.89),(2.23±0.89)and(4.27±0.82),the difference was statistically significant(t=9.374,3.098,13.306,P<0.05).The ODI scores of the two groups were at the 3rd day,7th day and 30th day after treatment were lower than those before treatment,and the differences of them between two groups were statistically significant(t=7.112,10.690,10.151,P<0.05).In 30 patients of observation group,the gap between the dural sac and the inner edge of facet joint on the affected side was larger than 4.0mm in 25 cases,and all of them can safely conduct puncture with targeting.Conclusion:The targeted epidural space block combined with acupotomy by adopting monitor with X-ray image can effectively improve the symptom of pain,and activities of daily life of LDH patients,which treatment is safe and effective.
