Gossner Johannes
Department of Clinical Radiology, Evangelisches Krankenhaus Göttingen-Weende; Göttingen, Germany -
Interv Neuroradiol. 2014 Oct 31;20(5):533-7. doi: 10.15274/INR-2014-10082. Epub 2014 Oct 17.
Selective nerve root infiltrations are frequently performed in patients with lumbar radiculopathy. Computed tomography (CT) is now commonly used for image guidance. Despite the widespread use of CT-guided lumbar nerve root infiltrations few studies have systematically examined the safety of this approach. In a two-year period, 231 lumbar nerve root infiltrations were performed on in-patients and were retrospectively reviewed. No major complications like inflammation (especially spondylodiscitis), large haematomas requiring surgery, severe allergic reactions or spinal ischaemia occurred. In accordance with other published studies, CT-guided lumbar nerve root infiltrations seem to be safe. To minimize the risk of catastrophic neurological complications due to spinal ischaemia, careful needle placement dorsal to the nerve root and the use of a non-particulate corticosteroid, like dexamethasone, are advocated.
选择性神经根浸润术常用于腰椎神经根病患者。计算机断层扫描(CT)目前常用于图像引导。尽管CT引导下腰椎神经根浸润术已广泛应用,但很少有研究系统地检查这种方法的安全性。在两年期间,对住院患者进行了231次腰椎神经根浸润术,并进行了回顾性分析。未发生炎症(尤其是脊椎椎间盘炎)、需要手术的大血肿、严重过敏反应或脊髓缺血等重大并发症。与其他已发表的研究一致,CT引导下腰椎神经根浸润术似乎是安全的。为了将脊髓缺血导致灾难性神经并发症的风险降至最低,提倡将针小心地置于神经根背侧,并使用非颗粒性皮质类固醇,如地塞米松。