膝关节神经:射频损伤在慢性膝关节疼痛中的应用。

The genicular nerve: radiofrequency lesion application for chronic knee pain.

机构信息

Pain Clinic, Department of Anesthesiology and Reanimation, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey.

Department of Anesthesiology and Reanimation, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey.

出版信息

Turk J Med Sci. 2017 Feb 27;47(1):268-272. doi: 10.3906/sag-1601-171.

Abstract

BACKGROUND/AIM: We investigated the short- and medium-term effectiveness of genicular nerve radiofrequency (RF) applied in patients with chronic knee pain due to osteoarthritis.

MATERIALS AND METHODS

Radiofrequency was performed in 49 patients with a diagnosis of knee osteoarthritis. VAS and WOMAC were measured at baseline and at 1, 4, and 12 weeks postprocedure. Under fluoroscopic guidance, the cannula was advanced percutaneously towards the area connecting the shaft to the epicondyle. The RF electrode was inserted through the cannula and the electrode tip temperature was raised to 80 °C for 90 s. One RF lesion was made for each genicular nerve.

RESULTS

Mean patient age was 64 ± 10.6. VAS score before the procedures was 8.9 ± 0.8, while 1, 4, and 12 weeks after the procedure it was 4.73 ± 3.23, 3.89 ± 2.9, and 3.93 ± 2.95, respectively. WOMAC score before the procedures was 64.26 ± 7.29, while 1, 4, and 12 weeks after the procedures it was 44.93 ± 13.18, 42.81 ± 13.15, and 43.04 ± 13.36, respectively.

CONCLUSION

RF neurotomy of genicular nerves led to significant pain reduction and functional improvement in a subset of elderly patients with chronic knee osteoarthritis pain, and thus may be an effective treatment in such cases.

摘要

背景/目的:我们研究了应用于膝骨关节炎慢性膝关节疼痛患者的神经射频(RF)的短期和中期效果。

材料和方法

对 49 例膝骨关节炎患者进行了 RF 治疗。在基线时以及治疗后 1、4 和 12 周时分别测量 VAS 和 WOMAC。在透视引导下,经皮将套管推进至连接轴和外髁的区域。将 RF 电极通过套管插入,将电极尖端温度升高至 80°C 持续 90 秒。每个关节支神经进行一次 RF 消融。

结果

患者平均年龄为 64 ± 10.6 岁。治疗前 VAS 评分为 8.9 ± 0.8,而治疗后 1、4 和 12 周时分别为 4.73 ± 3.23、3.89 ± 2.9 和 3.93 ± 2.95。治疗前 WOMAC 评分为 64.26 ± 7.29,而治疗后 1、4 和 12 周时分别为 44.93 ± 13.18、42.81 ± 13.15 和 43.04 ± 13.36。

结论

在一组患有慢性膝骨关节炎疼痛的老年患者中,关节支神经射频消融术导致疼痛显著减轻和功能改善,因此可能是此类病例的有效治疗方法。

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