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有后路脊柱内固定装置的患者行腰椎射频手术的安全性

Safety of Lumbar Spine Radiofrequency Procedures in Patients Who Have Posterior Spinal Hardware.

作者信息

Lamer Tim J, Smith Jolene, Hoelzer Bryan C, Mauck William D, Qu Wenchun, Gazelka Halena M

机构信息

*Division of Pain Medicine, Mayo Clinic, Rochester, Minnesota

Medical Center Anesthesiologists, Des Moines, Iowa.

出版信息

Pain Med. 2016 Sep;17(9):1634-7. doi: 10.1093/pm/pnv078. Epub 2016 Jan 13.

Abstract

OBJECTIVE

The purpose of this study was to determine whether the energy generated by an active radiofrequency (RF) cannula adjacent to lumbar spine hardware could result in heating of the hardware.

DESIGN

Prospective study.

SETTING

Tertiary care medical center.

SUBJECTS

Six patients with lumbar facet joint pain at the level adjacent to lumbar spine fusion hardware were studied.

METHODS

A total of 10 lumbar medial branch nerve radiofrequency lesion procedures were performed on six patients. A temperature probe was placed on the fusion hardware to continuously monitor the temperature of the hardware throughout the RF procedure.

RESULTS

The temperature of the fusion hardware increased in six of the 10 RF lesion procedures. During two of the procedures, the temperature rose rapidly to 42°C, at which time the procedure was ceased at that level.

CONCLUSION

This study demonstrated that radiofrequency lesioning to treat symptomatic facet joint pain in patients who have adjacent posterior lumbar fusion hardware may result in heat energy being transferred to the adjacent hardware. This may increase the risk of injury to the patient. Monitoring for a temperature increase is easily accomplished by inserting a temperature probe onto the surface of the hardware.

摘要

目的

本研究旨在确定邻近腰椎内固定装置的有源射频(RF)套管产生的能量是否会导致内固定装置发热。

设计

前瞻性研究。

地点

三级医疗中心。

研究对象

对6例腰椎融合内固定装置相邻节段腰椎小关节疼痛患者进行研究。

方法

对6例患者共进行了10次腰椎内侧支神经射频消融术。在射频手术过程中,将温度探头放置在内固定装置上,持续监测其温度。

结果

10次射频消融术中,有6次内固定装置的温度升高。在其中2次手术中,温度迅速升至42°C,此时该节段手术停止。

结论

本研究表明,对有邻近后路腰椎融合内固定装置的患者进行射频消融治疗症状性小关节疼痛,可能会导致热能传递至邻近的内固定装置。这可能会增加患者受伤的风险。通过在装置表面插入温度探头可轻松实现对温度升高的监测。

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