射频介入治疗腰椎间盘突出症的应用进展
Advances in the Application of Radiofrequency Interventional Therapy for Lumbar Disc Herniation
DOI: 10.12677/acm.2026.1682894, PDF,   
作者: 杨永宏:黑龙江中医药大学研究生院,黑龙江 哈尔滨;姜益常*:黑龙江中医药大学附属第一医院骨伤三科,黑龙江 哈尔滨
关键词: 腰椎间盘突出症;射频热凝;水冷射频;脉冲射频;低温等离子;弯针;双极;引导;Lumbar Disc Herniation; Radiofrequency Thermocoagulation; Water-Cooled Radiofrequency; Pulsed Radiofrequency; Coblation; Curved Needle; Bipolar; Guidance
摘要: 腰椎间盘突出症是以腰痛、活动受限、下肢放射性疼痛、麻木等为主要症状的综合征。对于这一临床常见病,介于保守和手术治疗之间的微创介入技术愈发获得认可。射频技术作为其中之一,已经在推广应用的过程中从多个角度有所发展。本文就其射频模式、穿刺技术、引导技术、联合疗法等进行综述,旨在为更深入、更创新地使用射频治疗腰椎间盘突出症提供参考及依据。
Abstract: Lumbar disc herniation is a syndrome primarily characterized by low back pain, limited mobility, radiating pain in the lower extremities, and numbness. For this common clinical condition, minimally invasive interventional techniques, which lie between conservative and surgical treatments, have increasingly gained recognition. As one of these techniques, radiofrequency technology has evolved in various aspects during its promotion and application. This article reviews its radiofrequency modes, puncture techniques, guidance techniques, and combination therapies, aiming to provide a reference and basis for a deeper and more innovative use of radiofrequency in the treatment of lumbar disc herniation.
文章引用:杨永宏, 姜益常. 射频介入治疗腰椎间盘突出症的应用进展[J]. 临床医学进展, 2026, 16(8): 1190-1196. https://doi.org/10.12677/acm.2026.1682894

参考文献

[1] 腰椎间盘突出症诊疗中国疼痛专家共识[J]. 中国疼痛医学杂志, 2020, 26(1): 2-6.
[2] 王平, 周鑫, 刘爱峰, 等. 靶点射频消融联合脉冲射频治疗腰椎间盘突出症的临床研究[J]. 中国疼痛医学杂志, 2019, 25(9): 699-702.
[3] Wang, J.C., Kabo, J.M., Tsou, P.M., Halevi, L. and Shamie, A.N. (2005) The Effect of Uniform Heating on the Biomechanical Properties of the Intervertebral Disc in a Porcine Model. The Spine Journal, 5, 64-70.
https://doi.org/10.1016/j.spinee.2004.10.047
[4] 朱峻松, 沈玉杰, 王宇, 等. 射频靶点热凝治疗腰椎间盘突出症对外周血中TNF-α和IL-1β的影响[J]. 中国医药导报, 2016, 13(30): 87-90.
[5] 李健, 路鹏飞. 射频消融技术治疗老年腰椎间盘突出症的康复评定及预后分析[J]. 科技导报, 2023, 41(23): 49-55.
[6] Cobbs, A., Alas, G., Yadav, R., Mayeux, J., Eckmann, M.S., Provenzano, D.A., et al. (2024) Water-Circulating Probes Significantly Modify Lesion Length and Axon Damage in Cooled Radiofrequency Ablations When Compared with Similar-Sized Standard Radiofrequency Probes in Rats. Regional Anesthesia & Pain Medicine, 49, 448-454.
https://doi.org/10.1136/rapm-2023-104554
[7] Desai, M.J., Ollerenshaw, J., Harrison, R., et al. (2015) Intervertebral Disc Temperature Mapping during Disc Biacuplasty in the Human Cadaver. Pain Physician, 2, E217-E223.
https://doi.org/10.36076/ppj/2015.18.e217
[8] Laboureyras, E., Rivat, C., Cahana, A. and Richebé, P. (2012) Pulsed Radiofrequency Enhances Morphine Analgesia in Neuropathic Rats. NeuroReport, 23, 535-539.
https://doi.org/10.1097/wnr.0b013e3283541179
[9] 郭强, 康超, 高晓猛, 等. 双极调压脉冲射频联合小剂量胶原酶治疗腰椎间盘突出症29例临床研究[J]. 陕西医学杂志, 2019, 48(12): 1627-1629+1633.
[10] 张荣宜, 王立奎, 朱本藩, 等. 低温等离子髓核消融术与胶原酶溶解术治疗颈椎间盘突出症的对比研究[J]. 中国疼痛医学杂志, 2018, 24(12): 912-916.
[11] 朱永强, 吴定权, 宋魁, 等. 低温等离子靶点消融治疗腰椎间盘突出症的临床价值分析[J]. 医学影像学杂志, 2021, 31(11): 1943-1946.
[12] Cosman, E.R., Dolensky, J.R. and Hoffman, R.A. (2014) Factors That Affect Radiofrequency Heat Lesion Size. Pain Medicine, 15, 2020-2036.
https://doi.org/10.1111/pme.12566
[13] Wondra, A., Gulhar, S., Brestle, M.D., Chou, J. and Desai, M.J. (2024) Bipolar Radiofrequency Ablation Lesion Areas and Confluence: An ex Vivo Study and Technical Report. Pain Practice, 24, 489-501.
https://doi.org/10.1111/papr.13323
[14] 杨扬, 朱亚文, 林建. 射频双电极针平行错位排列蛋清热凝物形态分析[J]. 江苏医药, 2012, 38(1): 21-23.
[15] 黄蘋, 董春英, 黄立荣, 等. 侧俯卧位MRI引导腰脊神经后根神经节射频消融术的手术体位护理[J]. 广州医药, 2024, 55(5): 562-566.
[16] 韩福康, 王富军, 贾峰, 等. 多维角度测绘在腰椎间盘突出症射频消融术的应用效果[J]. 微创医学, 2023, 18(4): 469-471.
[17] 王景, 徐瑞, 康学文, 等. 智能手机在人工全髋关节置换术中测量髋臼假体植入角度的应用[J]. 中国修复重建外科杂志, 2016, 30(9): 1061-1064.
[18] 高卿姬, 王建雄, 孙定平. 改良射频针技术在腰椎间盘射频消融术中的临床应用效果[J]. 青海医药杂志, 2023, 53(5): 44-47.
[19] 董蕊, 杨旭, 杜思扬, 等. CT三维重建引导低温等离子射频消融联合臭氧及胶原酶治疗腰椎间盘突出症的疗效分析[J]. 临床和实验医学杂志, 2023, 22(9): 991-994.