Clinical Study On Low Temperature Plasma Radiofrequency Ablation For The Treatment Of Lumbar Disc Herniatio

Lumbar disc herniation(lumbardischerniation,LDH)is a common disease of the spine.On the basis of lumbar disc degeneration,under the action of external force,part or all of the fibrous annulus is torn,protruding alone or with nucleus pulposus and cartilage endplate,stimulating sinus and vertebral nerve or lumbar nerve root,and low back pain is the main symptom."prolapse of lumbar intervertebral disc"does not exist in traditional Chinese medicine,and belongs to the category of "arthralgia" and "low back pain" according to its causes and symptoms.The incidence of lumbar disc herniation is based on the degeneration of lumbar intervertebral disc,and then due to the feeling of external evil,fall injury,physical weakness,overwork and so on,resulting in deficiency of kidney essence and qi,loss of muscles and bones,intervertebral disc degeneration,and finally the formation of the disease.According to the Traditional Chinese Medicine Industry Standard of the People’s Republic of China,it can be divided into:blood stasis and qi stagnation syndrome,cold-dampness obstruction syndrome,dampness-heat obstruction syndrome,liver and kidney deficiency syndrome.Objective:To investigate the clinical effect and influencing factors of percutaneous lumbar disc nucleoplasty for lumbar disc herniation.Methods:The data of 50 patients with lumbar disc herniation who underwent percutaneous lumbar disc nucleoplasty in the Department of Orthopaedics,Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University from January 2022 to February 2022 were retrospectively analyzed,and the ODI score,VAS score and MacNab standard evaluation results of patients before,immediately after and 1 year after surgery were collected,respectively.To evaluate the clinical effect of percutaneous lumbar disc nucleoplasty for lumbar disc herniation.According to the MacNab standard results of the patient at the last follow-up,univariate analysis was performed on the patient’s gender,body mass index(BMI),surgical segment,main symptoms,preoperative intervertebral height,preoperative lumbar Pfirrmann grade,TCM syndrome type,age and course of disease.Subsequently,multiple factor logistic regression analysis was performed on age,disease course,preoperative vertebral space height,and TCM syndrome type,so as to explore the influencing factors of postoperative effect of percutaneous lumbar disc nucleoplasty.Results:At the last follow-up,the clinical symptoms of the patients were significantly better than those before operation.The ODI scores of all patients before operation,immediately after operation and 1 year after operation were 22.34 ± 5.53,12.26 ± 4.91,9.66 ± 8.31 respectively.Compared with the ODI score before operation,the ODI score immediately after operation and the ODI score one year after operation were significantly different from those before operation by paired t test(P<0.05),and the clinical symptoms were significantly improved at the last follow-up.The VAS scores of all patients before operation,immediately after operation and 1 year after operation were 5.20 ± 1.18,2.76±1.12,2.8±1.97.Compared with the VAS score before operation,the VAS score immediately after operation and the VAS score one year after operation were significantly different from those before operation by paired t test(P<0.05),and the ODI score at 1 year follow-up was significantly lower than that immediately after operation(P<0.05).During the follow-up one year after operation,according to the MacNab criteria of lumbar function,9 cases were excellent,22 cases good,9 cases fair and 10 cases poor.The total.excellent and good rate was 62%.The results of univariate analysis showed that age,course of disease,preoperative intervertebral space height and TCM syndrome type were the main factors affecting the clinical curative effect,while multivariate regression analysis showed that the patients with young age,short course of disease and large preoperative intervertebral space height were relatively good in clinical effect and prognosis.Conclusion:Percutaneous lumbar disc nucleoplasty has a good short-term effect in the treatment of lumbar disc herniation,and the clinical effect of lumbar disc herniation patients with young age,short course of disease and large preoperative intervertebral space is relatively good.Percutaneous lumbar disc nucleoplasty has the advantages of less trauma,time period,good curative effect and less complications,so it can be widely used in clinic.