Filippiadis Dimitrios K, Velonakis Georgios, Malagari Aikaterini, Alexopoulou Efthymia, Brountzos Elias, Kelekis Nikolaos, Kelekis Alexios
2nd Radiology Department, University General Hospital "ATTIKON", 1 Rimini str, 12462, Athens, Greece,
Skeletal Radiol. 2015 Sep;44(9):1327-31. doi: 10.1007/s00256-015-2154-0. Epub 2015 May 1.
Baastrup disease refers to degenerative changes of adjacent spinous processes with resultant back pain. The purpose of this study is to assess the safety and efficacy of percutaneous, fluoroscopy-guided infiltrations in a consecutive series of patients suffering from Baastrup disease.
From January 2009 until December 2013, 55 patients suffering from Baastrup disease (diagnosed clinically and by imaging findings) underwent percutaneous, fluoroscopy-guided infiltration. The position of the needle (22-gauge spinal needle) was fluoroscopically verified at the level of interspinous ligament. Then a mixture of long-acting corticosteroid with local anesthetic (1.5/1 cc) was injected. A questionnaire with NVS scale helped in assessing pain relief degree, life quality, and mobility improvement.
In the patients of our study, a total of 67 sessions was performed. In 12/55 patients (22%), a second infiltration was performed within 7-10 days apart from the first one. The end point was 1 year post-treatment. Patients were followed 1 week after the first injection for a subsequent treatment and then if asymptomatic re-controlled in 3-6 and 12 months. Comparing the pain scores prior (mean value, 8.18 ± 1.44 NVS units) and after (mean value, 0.62 ± 0.93 NVS units) there was a mean decrease of 7.56 ± 1.68 NVS units (p < 0.001) on terms of pain reduction, effect upon mobility and life quality. There were no clinically significant complications noted in our study.
Fluoroscopy-guided infiltrations seem to be a feasible, efficacious, and safe approach for pain reduction and mobility improvement in patients with Baastrup disease.
巴斯楚普病是指相邻棘突的退行性改变并伴有背痛。本研究的目的是评估在一系列连续的巴斯楚普病患者中,经皮荧光镜引导下浸润治疗的安全性和有效性。
2009年1月至2013年12月,55例患有巴斯楚普病(经临床诊断和影像学检查确诊)的患者接受了经皮荧光镜引导下浸润治疗。在荧光镜下确认22号脊麻针在棘间韧带水平的位置。然后注射长效皮质类固醇与局部麻醉剂的混合液(1.5/1毫升)。使用NVS量表的问卷有助于评估疼痛缓解程度、生活质量和活动能力改善情况。
在我们的研究患者中,共进行了67次治疗。12/55例患者(22%)在第一次治疗后7 - 10天内进行了第二次浸润治疗。终点为治疗后1年。首次注射后1周对患者进行随访以确定后续治疗情况,然后如果无症状则在3 - 6个月和12个月时再次进行检查。比较治疗前(平均值,8.18±1.44 NVS单位)和治疗后(平均值,0.62±0.93 NVS单位)的疼痛评分,在疼痛减轻、对活动能力和生活质量的影响方面,平均降低了7.56±1.68 NVS单位(p < 0.001)。我们的研究中未发现具有临床意义的并发症。
荧光镜引导下浸润治疗似乎是一种可行、有效且安全的方法,可减轻巴斯楚普病患者的疼痛并改善其活动能力。