Aubry Sébastien, Kastler Bruno, Bier Vincent, Hadjidekov Vassil, Hussein Hussein Haj, Fergane Bernard
Département de Radiologie, CHU Sherbrooke, QC, Canada.
Neuroradiology. 2009 Mar;51(3):163-8. doi: 10.1007/s00234-008-0480-9. Epub 2008 Dec 4.
The aim of this study was to evaluate the effectiveness of computed tomography (CT)-guided infiltration in the treatment of Arnold's neuralgia.
A retrospective study included 31 patients suffering from Arnold's neuralgia and having undergone a total of 45 CT-guided infiltrations of the greater occipital nerve (GON), in a proximal site (emergence of the GON, technique 1, n = 24) or in two proximal sites (emergence of the GON and at the site of the first bend of the GON drawn by the GON, technique 2, n = 21). Infiltration was considered to be effective when pain relief was equal to or greater than 50% for at least 1 month.
There was no significant difference between the two techniques regarding immediate pain relief effect (53.3% for technique 1 vs. 60.5% for technique 2, p = 0.5), but technique 2 yielded better persistence of pain relief effect (p = 0.01), leading to a significantly higher percentage of effective infiltrations with technique 2 (p = 0.03).
Infiltrations carried out in a single site yield results that are comparable to those previously published. Infiltrations in two sites provide significantly better results and should now be preferred to other single-site techniques in order to reduce the rate of failure or recurrence of Arnold's neuralgia.
本研究旨在评估计算机断层扫描(CT)引导下浸润治疗阿诺德神经痛的有效性。
一项回顾性研究纳入了31例患有阿诺德神经痛且总共接受了45次CT引导下枕大神经(GON)浸润的患者,浸润部位为近端(GON穿出点,技术1,n = 24)或两个近端部位(GON穿出点以及由GON绘制的GON第一个弯曲处,技术2,n = 21)。当疼痛缓解至少持续1个月且缓解程度等于或大于50%时,浸润被认为是有效的。
两种技术在即时疼痛缓解效果方面无显著差异(技术1为53.3%,技术2为60.5%,p = 0.5),但技术2在疼痛缓解效果的持续性方面更好(p = 0.01),导致技术2的有效浸润百分比显著更高(p = 0.03)。
在单一部位进行的浸润产生的结果与先前发表的结果相当。在两个部位进行浸润可提供明显更好的结果,为降低阿诺德神经痛的失败率或复发率,现在应优先于其他单部位技术。