侧隐窝电针治疗腰椎间盘突出症的临床应用
Clinical Application of Lateral Recess Electroacupuncture in the Treatment of Lumbar Disc Herniation
刘润贵1
作者信息
- 1. 重庆明好医院疼痛康复科，重庆 400050
- 折叠
摘要
目的：探讨侧隐窝电针（Lateral Recess Electroacupuncture, LREA）前靶位治疗腰椎间盘突出症的临床疗效、电生理特征及技术参数。方法：对3例不同类型腰椎间盘突出症患者（中央型1例、右侧型1例、左侧型1例），采用盲穿法或DR引导将穿刺针置入腰椎侧隐窝前界（抵椎体后缘/纤维环后缘），连接低频电针仪（2 Hz），实施侧隐窝电针治疗，观察电刺激反应、技术参数及临床疗效。结果：3例患者均呈现典型的"运动-感觉分离"现象，电刺激诱发明确的下肢肌肉节律性抽动（腓肠肌、胫前肌等），但无下肢放射性麻痛或异感。验证阈值0.8-0.9 mA，治疗电流0.6-0.9 mA，治疗时间10-30 min。病例1（中央型）3次治疗后VAS降至0分；病例2（右侧型）4次治疗后症状完全消失；病例3（左侧型）4次治疗后麻木消失、疼痛减轻。总有效率100%（3/3），无严重并发症。结论：侧隐窝电针前靶位可精准激活腹根运动纤维，对中央型及侧旁型腰椎间盘突出症均具有显著镇痛效应，其"运动-感觉分离"现象为椎管内神经调控提供了新的解剖-生理证据。三维有效空间窗约3-5 mm，个体化深度参数56-70 mm。
Abstract
Objective: To investigate the clinical efficacy, electrophysiological characteristics, and technical parameters of anterior target lateral recess electroacupuncture (LREA) in the treatment of lumbar disc herniation. Methods: Three patients with different types of lumbar disc herniation (central type, right-sided type, and left-sided type) were treated with blind puncture or DR-guided puncture to place the needle at the anterior border of the lateral recess (against the posterior vertebral body/annulus fibrosus), connected to a low-frequency electroacupuncture device (2 Hz). The electrical stimulation response, technical parameters, and clinical efficacy were observed. Results: All three patients showed a typical "motor-sensory dissociation" phenomenon: definite lower limb muscle rhythmic twitching (gastrocnemius, tibialis anterior, etc.) was induced, but no radiating numbness or pain in the lower limbs was reported. The verification threshold was 0.8-0.9 mA, the treatment current was 0.6-0.9 mA, and the treatment duration was 10-30 min. Case 1 (central type): VAS decreased to 0 after 3 treatments; Case 2 (right-sided type): symptoms completely disappeared after 4 treatments; Case 3 (left-sided type): numbness disappeared and pain was relieved after 4 treatments. The overall effective rate was 100% (3/3), with no serious complications. Conclusion: The anterior target of LREA can accurately activate ventral root motor fibers and has significant analgesic effects on both central and lateral lumbar disc herniation. The "motor-sensory dissociation" phenomenon provides new anatomical and physiological evidence for intraspinal nerve regulation. The three-dimensional effective spatial window is approximately 3-5 mm, with individualized depth parameters of 56-70 mm.关键词
侧隐窝电针/腰椎间盘突出症/腹根/运动-感觉分离/神经调控/病例系列。Key words
lateral recess electroacupuncture/lumbar disc herniation/ventral root/motor-sensory dissociation/neuromodulation/case series引用本文复制引用
刘润贵.侧隐窝电针治疗腰椎间盘突出症的临床应用[EB/OL].(2026-10-08)[2026-10-09].http://www.paper.edu.cn/releasepaper/content/202610-2.学科分类
外科学
