Landa Joshua, Kim Yong
Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York 10016, USA.
Bull NYU Hosp Jt Dis. 2012;70(1):6-10.
Epidural spinal injections can be administered via a translaminar or transforaminal route, depending on the clinical scenario. When it is more desirable to target a specific nerve root, a transforaminal approach is typically used, and when the target is more diffuse, a translaminar method is chosen. Both are commonly used and can be utilized similarly in the lumbar or cervical spine. However, it is essential that the clinician understand the risks and benefits of these injections. In the lumbar spine, both translaminar epidural steroid injections (TLESI) and transforaminal epidural steroid injections (TFESI) have been shown to provide up to 6 months of pain relief, though long-term benefits are less reliable. In the cervical spine, translaminar injections may provide longer relief and have a lower complication rate than cervical transforaminal injections. Proper technique is essential to minimize the rate of these rare but occasionally severe complications.
硬膜外脊髓注射可通过经椎板或经椎间孔途径进行,具体取决于临床情况。当更希望针对特定神经根时,通常采用经椎间孔途径;当目标更弥散时,则选择经椎板方法。两种方法都常用,在腰椎或颈椎中使用方式相似。然而,临床医生必须了解这些注射的风险和益处。在腰椎,经椎板硬膜外类固醇注射(TLESI)和经椎间孔硬膜外类固醇注射(TFESI)均已显示可提供长达6个月的疼痛缓解,尽管长期益处不太可靠。在颈椎,经椎板注射可能提供更长时间的缓解,且并发症发生率低于颈椎经椎间孔注射。正确的技术对于将这些罕见但偶尔严重的并发症发生率降至最低至关重要。