Siegenthaler Andreas
Bereich für Schmerztherapie, Universitätsklinik für Anästhesiologie und Schmerztherapie, Universitätsspital Bern.
Ther Umsch. 2011 Sep;68(9):527-30. doi: 10.1024/0040-5930/a000207.
When conservative treatment modalities provide inadequate relief, interventional techniques play an important role in the management of chronic pain patients. They are performed in diagnostic or therapeutic intention (or both) and either directly target the pain generating anatomic structure (e.g. intraarticular joint injections) or the neural structures which are thought to mediate the experience of pain (e.g. facet joint nerve blocks, spinal cord stimulation). In order to enhance precision and patient safety, these interventions are performed with image guidance; of which fluoroscopy is the most commonly used technique. CT- or Ultrasound-guided techniques are also performed. This article is an overview of the indications and results of the most commonly performed interventional techniques used in chronic pain treatment with focus on spinal interventional procedures.
当保守治疗方法无法提供足够的缓解时,介入技术在慢性疼痛患者的管理中发挥着重要作用。这些技术以诊断或治疗为目的(或两者兼具),要么直接针对产生疼痛的解剖结构(如关节内注射),要么针对被认为介导疼痛体验的神经结构(如小关节神经阻滞、脊髓刺激)。为了提高精准度和患者安全性,这些干预措施在影像引导下进行;其中荧光透视是最常用的技术。也会采用CT或超声引导技术。本文概述了慢性疼痛治疗中最常用的介入技术的适应症和结果,重点是脊柱介入手术。