Abstract: 【Abstract】〓Objective〓To investigate the effect of modified selective nerve root block in multiple segmental degenerative lumbar disease. Methods〓Seventy-one patients with multiple segmenatl degenerative lumbar disease were included in the study, for whom the vertebral disease were hard to perform accurate positioning by radiological examination. All the patients underwent modified selective nerve root block from November 2010 to February 2014. After the modified selective nerve root block, the corresponding treatment was performed to define the responsible vertebral bodies and the responsible nerve root. The preoperative assessment and the post operative efficacy in 7 days,3 months. 6 months and last follow-up after operation were investigate by Japanese Orthopaedic Association(JOA), pain visual analog score(VAS) modified MacNab criteria. Results〓 All cases received follow-up for 6 to 36 months after surgery(an average of 19.1 months). Postoperative VAS scores and JOA scores of different periods were obviously improved than preoperative ones according to the modified MacNab criteria evaluation. Of 71 patients, clinical efficacy was optimal in 53 cases, good in 13 cases, poor in 3, and 2 cases failed. Excellent or good outcomes were obtained in 92.9%. Conclusion〓The modified selective nerve root was effective for diagnosis of multiple segmental degenerative lumbar in patients whose disease vertebral bodies were hard to be defined.

Key words: Lumbar vertebrae, Locating diagnosis , Nerve block, Multiple segmental

摘要： 【摘要】 目的 探讨改良选择性神经根阻滞术在多节段退行性腰椎疾病诊断中的应用及临床价值。方法〓回顾分析本院从2010年11月~2014年2月收治的术前不能准确定位的多节段退行性腰椎疾病患者71例,行改良选择性神经根阻滞术后明确责任间隙及责任神经根之后行相应处理。随访并比较患者术前及术后7天,3个月,6个月及末次随访时日本骨科学会(JOA)及疼痛视觉模拟量表(VAS)评分,并依据改良的MacNab 标准对治疗效果进行评价。结果〓术后所有病例均获得随访,随访时间为6~36个月,平均19.1个月。术后不同时间段的VAS评分及JOA评分均较术前有明显改善,按照改良的MacNab标准评定:本组71患者中,优53例、良13例、差3例,无效2例。优良率为92.9%。结论〓改良方法操作对术前不能准确定位的多节段退行性腰椎疾病,具有诊断率高、敏感性高、特异性强的特点,是影像学检查的有益补充,对下一步治疗方案的制定具有很好的指导意义。

关键词: 多节段, 神经阻滞, 定位诊断, 腰椎