Observation On The Effect Of Ultrasound-guided Nerve Block Combined With Ozone Injection In The Treatment Of Lumbar Spinal Nerve Posterior Branch Syndrome

Objective:To observe the effect of ultrasound-guided nerve block combined with ozone injection in the treatment of lumbar spinal nerve posterior branch syndrome,comparing with the effect of simple nerve block,and to observe the differency between two groups.Methods:Lumbar spinal nerve posterior branch syndrome is a syndrome characterized by pain in the lower back,buttocks,and posterolateral thighs,psoas muscle spasms,and movement disorders due to stimulation of the dorsal ramus of the lumbar spinal nerve.According to the diagnostic criteria of the posterior branch syndrome of the lumbar spinal nerve,60 patients who visited our outpatient department from July 2019 to November 2021 were collected and divided into 2 groups by random number table method,with 30 cases in each group.Ozone group(ultrasound-guided nerve block combined with ozone injection,group O)and ultrasound-guided nerve block group(ultrasound-guided nerve block,group N).Group O underwent nerve block and ozone injection with.,3ml of mixed liquid(methylprednisolone sodium succinate 40 mg + 2%lidocaine 5ml,diluted to 20 ml with normal saline)+ 30mg/L medical Ozone 3ml;N group received simple nerve block treatment,each point was injected with 3ml of mixed liquid(methylprednisolone sodium succinate 40 mg + 2% lidocaine 5ml,diluted with normal saline to 20ml).Treatment was given once a week for 3 consecutive weeks.The general information of the patients(sex,age,course of disease)was collected.Observation indicators were visual analogue scale(VAS),OSWESTRY disability index(ODI)before treatment,1w,4w,8w,12 w after treatment,and the effective rate at 12 w after treatment(VAS score was higher than improvement >50% before treatment),and related complications.The general data,VAS score and ODI score before and after treatment between the two groups were analyzed by two independent samples t test or rank sum test;the comparison of each time point within the group was by the analysis of variance of repeated measures data;the 12-week effective rate was compared by a four-table table card square inspection.P<0.05 was considered statistically significant.Results:1.General data conformed to normal distribution,expressed as mean ± standard deviation,and the statistical method used two independent samples t-test;VAS and ODI score data conformed to skewed distribution,expressed as median(interquartile range),and statistical method used two independent samples rank sum test.2.VAS score after treatment: The VAS scores at each time point after treatment in the two groups were significantly lower than those before treatment(P<0.05).The comparison between groups O and N showed that at 1w,it was 5(5,6)vs.5(4,6),P=0.813;at 4w,it was 4(3,4)vs.5(4,5),P=0.000;3(2,3)vs.3(3,4)at 8w,P=0.000;2(1,2)vs.2(2,3)at 12 w,P=0.007.3.ODI score after treatment: The ODI scores at each time point after treatment in the two groups were significantly lower than those before treatment(P<0.05).The comparison between groups O and N showed that at 1w,it was 25(25,26)vs.25(24,26),P=0.654;at 4w,it was 21(19,22)vs.26(24,26)26),P=0.000;17(16,18)vs.25(24,27)at8w,P=0.000;12w,16(15,17)vs.25(23,26),P=0.000.4.The comparison of curative effect at 12 w after treatment showed that the effective rate of group O was higher than that of group N,90.0% vs.66.7%,P=0.028,with statistical significance.5.Complications: There were no complications such as injection pain,bleeding,infection and new pain in both groups.Conclusion:Ultrasound-guided nerve block combined with ozone injection can effectively treat lumbar spinal nerve posterior branch syndrome.The pain relief and functional improvement at 4w,8w,and 12 w are better than those of simple nerve block,and the effective rate at 12 w is better than that of simple nerve block.