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[超声检查在老年患者骶髂后韧带注射中的应用价值]

[Usefulness of ultrasound sonography in performing posterior sacroiliac ligament injection in elderly patients].

作者信息

Nakamura Kanna, Matsumoto Sonoko, Enomoto Tatsuya, Hara Atsuko, Mitsuhata Hiromasa

出版信息

Masui. 2014 Dec;63(12):1324-8.

Abstract

BACKGROUND

The sacroiliac joint (SIJ) is recognized as a potential source for low back pain especially in elderly people. Previous studies indicated that in patients with SIJ pain, posterior sacroiliac ligament injections are more effective than intra articular injections. The aim of this study was to assess usefulness of ultrasound sonography (US) in performing posterior sacroiliac ligament injection.

METHODS

We examined SIJ and ligaments, and injected local anesthetics using ultrasonography. US guided needle insertions were performed. We also examined the cadevar of a 74-year-old woman to examine SIJ anatomy.

RESULTS

US was performed in 61 male and 97 female outpatients (N = 158) with a mean age of 72.8 ± 10.9. US examination of the SIJ is difficult to perform because of its complex anatomy, and wide range of normal variations, and relative inaccessibility by surface scanning. The long posterior sacroiliac ligament (LPSL) is visualized as a hyper echoic laminated linear structure. We were able to confirm needle placement and area affected by local anesthetics.

CONCLUSIONS

Our study suggests that US can be useful in performing posterior sacroiliac ligament injections. Sufficient anatomical knowledge and extensive US experience are essential in performing these injections.

摘要

背景

骶髂关节(SIJ)被认为是下腰痛的潜在来源,尤其是在老年人中。先前的研究表明,在骶髂关节疼痛患者中,骶髂后韧带注射比关节内注射更有效。本研究的目的是评估超声(US)在进行骶髂后韧带注射中的实用性。

方法

我们使用超声检查骶髂关节和韧带,并注射局部麻醉剂。进行超声引导下的针插入操作。我们还检查了一名74岁女性的尸体以研究骶髂关节解剖结构。

结果

对61名男性和97名女性门诊患者(N = 158)进行了超声检查,平均年龄为72.8±10.9岁。由于骶髂关节解剖结构复杂、正常变异范围广以及通过表面扫描相对难以触及,因此对其进行超声检查很困难。骶髂后长韧带(LPSL)表现为高回声分层线性结构。我们能够确认针的位置以及受局部麻醉剂影响的区域。

结论

我们的研究表明,超声可用于进行骶髂后韧带注射。进行这些注射时,足够的解剖学知识和丰富的超声经验至关重要。

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