结合皮肤内镜腰椎间盘切除术与臭氧注射用于腰椎间盘和ferroptosis抑制:一个随机临床试验
Hanbin Wang1,2, Li Xu1,2, Jiayi Deng1,2,3
11The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou First People's Hospital, Hangzhou.
Journal of neurosurgery. Spine
|January 23, 2026
概括
穿皮内镜腰椎间盘切除术 (PELD) 结合臭氧注射有效治疗腰椎间盘 (LDH). 较高的臭氧度 (30微克/毫升) 通过抑制疼痛缓解的关键机制铁亡,改善了早期恢复.
科学领域:
- 最少侵入性的脊柱手术
- 臭氧治疗的应用 臭氧治疗的应用
- 在疼痛管理中的生物标志物分析.
背景情况:
- 腰椎间盘 (LDH) 是腰部疼痛的一个常见原因.
- 穿皮内镜腰椎切除术 (PELD) 是一种已确立的LDH的最小侵入性治疗方法.
- 铁化在LDH疼痛中的作用和臭氧治疗的潜力需要进一步研究.
研究的目的:
- 为了评估PELD与LDH的周围根性臭氧注射相结合的疗效.
- 探讨铁灭菌在缓解与LDH臭氧治疗相关的疼痛中的作用.
- 为了比较不同臭氧度 (20微克/毫升与30微克/毫升) 作为PELD的辅助.
主要方法:
- 60名LDH患者被随机分为三个组:仅PELD,PELD+20μg/ml臭氧和PELD+30μg/ml臭氧.
- 评估的结果包括视觉模拟量表 (VAS),奥斯威斯特残疾指数 (ODI),坦帕运动恐惧症量表-11 (TSK-11),以及修改的Macnab标准.
- 在手术前和手术后测量了 Nrf2,GPX4 和谷氨 (GSH) 的血清水平,并使用受体操作特征 (ROC) 分析进行生物标志物预测.
主要成果:
- 所有治疗组都显示了显著的术后改善 (p < 0.05).
- 接受臭氧注射的组 (B和C) 在1周和4周的VAS,ODI和TSK-11得分显著降低,与单独PELD (A组) 相比.
- 与20微克/毫升组 (B) 相比,30微克/毫升臭氧组 (C) 显示出更好的早期恢复 (p <0.05),Nrf2,GPX4和GSH水平显著升高.
结论:
- 周周激素臭氧注射是一种安全有效的PELD补充剂,用于改善LDH患者的治疗结果.
- 一个30μg/ml的臭氧度提供优越的早期恢复,可能通过ferroptosis抑制.
- 在这种治疗方法中,Nrf2,GPX4和GSH作为缓解疼痛的重要预测生物标志物.
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