Clinical Observation Of Needle-knife Combined With Low Temperature Plasma Ablation In The Treatment Of Cervical Spondylotic Radiculopathy

Objective:To observe the clinical effect of needle knife release combined with low temperature plasma ablation in the treatment of cervical spondylotic radiculopathy.Method:According to the diagnostic criteria,inclusion criteria and exclusion criteria,90 patients with cervical spondylotic radiculopathy were selected from our hospital in outpatient or ward,from 2017.10~2018.10.They were randomly divided into three groups A,B and C.Group A: needle-knife release treatment group,Group B:low temperature plasma ablation treatment group,and Group C: low temperature plasma ablation combined with needles.There were 30 cases in each group.In group A,needle-knife was used to treat cervical spondylotic radiculopathy.The first needle-knife release included 9 points,were interspinous processes and bilateral articular processes of C4-5,C5-6 and C6-7.The second needle-knife release included posterior tubercles of C4,C5 and C6 transverse processes.The third needle-knife release included bilateral suprascapular angle,middle point of superior trapezius muscle and supraspinatus muscle point(Square suprascapular spine1-1.5 cm).infraspinatus point(the middle of below scapula muscle 1-2 cm),small round muscle scapula outer point.Once a week,three consecutive times.Group B was treated with low temperature plasma ablation under C-arm fluoroscopy.Routine observation was made after operation.Group C were received three consecutive needle-knife releases on the first day after low temperature plasma ablation treatment,and selected the same site as group A.There was no significant difference in sex,age,course of disease and location between the three groups before treatment,which was comparable.The VAS scores,clinical symptoms and signs grading scores were recorded before treatment,1 week,3 weeks and 3 months after treatment.The latency of F wave of EMG was compared before treatment and 3 months after treatment.The overall efficacy of the three groups after treatment was analyzed.All data were processed by SPSS 20.0 software package.Result: 1.After treatment,there were significant differences in VAS score and clinical symptoms and signs score between the three groups before and after treatment(P < 0.01),indicating that all three treatments had significant effects;after treatment,there were significant differences among the three groups(P < 0.05),indicating that group C(needle knife release combined with low temperature plasma ablation treatment group)was in the treatment of cervical spondylotic radiculopathy,mild.The effect of relieving pain and improving clinical symptoms and signs of patients was better than that of group A(needle-knife treatment group)and group B(low temperature plasma ablation treatment group).2.Three months after treatment,the latency of F-wave of median nerve and Ulnar nerve in EMG was significantly different among three groups(P < 0.01),indicating that all three treatments can promote the recovery of upper limb nerve function.The latency of median nerve and Ulnar nerve in group C(needle knife release combined with low temperature plasma ablation treatment group)was better than that in group A(needle-knife release group).)And group B(low temperature plasma ablation treatment group),showed that needle-knife combined with low temperature plasma ablation in the treatment of cervical spondylotic radiculopathy has a better effect on the recovery of nerve function.3.After treatment,the overall effective rate of the three groups were 70% in group A(needle-knife treatment group),83.3% in group B(low temperature plasma ablation treatment group),90% in group C(needle knife release combined with low temperature plasma ablation treatment group).This indicated that the overall clinical efficacy and marked efficiency of group C were better than those of group A and group B,indicating that the combined therapy of needle knife release combined with low temperature plasma ablation treatment for nerve root was superior Type A cervical spondylosis has better clinical effect.Conclusion: Low temperature plasma ablation combined with needle-knife release in the treatment of cervical spondylotic radiculopathy can more effectively alleviate upper limb numbness,neck and shoulder pain,and promote the recovery of nerve function.