Study Of Radiofrequency Thermocoa-Gulation Combined With Epidural Block For Treatment Of Lumbar Intervertebral Disc Herniation

Part one:Clinical study of radiofrequency thermocoagulation combined with epidural block for treatment of lumbar intervertebral disc herniationObjective: To observe the clinical efficacy and safety of radiofrequency thermocoagulation (RA) combined with epidural block (EA)for treatment of lumbar intervertebral disc herniation.Methods: Ninty seven patients of Lumbar disc herniation were divided into two groups. RA combined with EA group(group R, n=47), accepted the epidural drugs injection , after 1 week RA was taken . The EA group (group E, n=50) accepted the same epidural drugs injection for 3 times. The VAS scores,clinical efficacy and complication were evaluated .Results: After the treatment, VAS scores both groups decreased significantly compared with before the treatment . VAS scores of the 9th day and the 2nd day after the treatment were 4.36±0.73,1.32±0.41 in the group R and 5.13±1.57,1.74±0.59 in the group E( P<0.01 ). On the 9th day after the treatment, the satisfactory rate was 76.6% in the group R, which was much higher than the group E( 60.0%). On the 2ed day after the treatment , the curative satisfactory rate in the group R was 82.9% higher than the group E (72.0%). The curative satisfactory rates were 86.5%,78.4%,70.3% for 3 month,6 month,1 year after RA treatment.Conclusion: Thermocoagulation combined with epidural block for treatment of lumbar intervertebral disc herniation is an effective,safe method. Part two:Effect of radiofrequency thermocoagulation combined with epidural block for treatment of lumbar intervertebral disc herniation onβ-endorphinObjective: To determine the effect of before and after the treatment of LDH on serumβ-endorphin(β-EP). To explore the relationship between serumβ-EP and clinical efficacy.Methods: Thirteen patients of LDH were divided into two groups. RA combined with EA group(group R, n=7), accepted the epidural drugs injection , after 1 week RA was taken . The EA group (group E, n=6) accepted the same epidural drugs injection for 3 times. Levels of serumβ-EP were evaluated . The normal group(group N, n=5) were five healthy people.Results: Before treatment,levels of serumβ-EP were lower in both groups than general persons. After treatment serumβ-EP levels raised, and had significant differences compaired with before treatment(P<0.05).But there was no significant difference between group R and E.Conclusion: Low lever of serumβ-EP may be one of mechanisms of pain in LDH patients . RA combined with EA can raise serumβ-EP levels,release pain of LDH patients.