Department of Neurosurgery, Cham Teun Teun Hospital, Guri, Korea.
Department of Neurosurgery, Spine and Spinal Cord Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Pain Physician. 2017 Sep;20(6):E941-E949.
Cervical disc disease is a common and occasionally disabling condition, occurring as a natural consequence of aging in the vast majority of the adult population. Percutaneous epidural neuroplasty (PEN) has been used to deliver highly concentrated drugs for chronic neck pain and to prevent scarring in cases refractory to conventional epidural blocks. However, the clinical course after PEN in cervical disc disease is not well-documented.
The purpose of this study was to evaluate the efficacy of cervical PEN for single-level cervical disc disease.
A retrospective observational study.
A consecutive series of 100 patients who underwent cervical PEN for single-level disc disease (bulging or protrusion) were included in this study. Preoperatively, all patients underwent magnetic resonance imaging (MRI), and visual analog scale (VAS) scores as well as Odom's criteria were measured preoperatively and at post-operative follow-up visits (one, 3, 6, and 12 months).
The results of this study are limited by the lack of a control group that did not undergo treatment with PEN.
Additional block therapy was performed in 58 patients (58.0%). Subsequent surgery was performed in 10 patients (10.0%, excluded from data of clinical follow-up). Mean neck pain and VAS arm pain scores for all follow-up patients decreased from 6.82 and 4.74 preoperatively to 2.18 and 1.87 at 12 months after PEN (P < 0.001). More than 80% and 40% of all patients with and without additional block therapy after cervical PEN, respectively, showed good and excellent outcomes according to Odom's Criteria during 12 months of follow-up. During this follow-up period, no severe complications related to the procedure were observed.
Cervical PEN was shown to be a safe and effective treatment for neck and arm pain in single-level disc disease during 12 months of follow-up. Key words: Neck pain, cervical disc disease, pain management, percutaneous epidural neuroplasty, adhesiolysis, clinical course.
颈椎间盘疾病是一种常见的、偶尔会导致残疾的疾病，在绝大多数成年人群体中，它是衰老的自然结果。经皮硬膜外神经松解术（PEN）已被用于为慢性颈部疼痛提供高度浓缩的药物，并防止常规硬膜外阻滞无效的病例发生瘢痕形成。然而，颈椎间盘疾病中 PEN 的临床过程并未得到很好的记录。
本研究旨在评估颈椎 PEN 治疗单节段颈椎间盘疾病的疗效。
回顾性观察研究。
本研究纳入了 100 例因单节段椎间盘疾病（膨出或突出）行颈椎 PEN 的连续患者。所有患者术前均行磁共振成像（MRI）检查，并在术前和术后随访（1、3、6 和 12 个月）时测量视觉模拟评分（VAS）和 Odom 标准评分。
本研究的结果受到缺乏未接受 PEN 治疗的对照组的限制。
58 例（58.0%）患者行额外阻滞治疗。10 例（10.0%）患者随后行手术（排除临床随访数据）。所有随访患者的颈部疼痛和 VAS 手臂疼痛评分从术前的 6.82 和 4.74 分别降至 PEN 术后 12 个月的 2.18 和 1.87（P<0.001）。在接受和未接受颈椎 PEN 后行额外阻滞治疗的患者中，分别有超过 80%和 40%的患者根据 Odom 标准在 12 个月的随访中表现出良好和优秀的结果。在随访期间，未观察到与该手术相关的严重并发症。
在 12 个月的随访中，颈椎 PEN 被证明是治疗单节段椎间盘疾病引起的颈部和手臂疼痛的一种安全有效的方法。
颈部疼痛、颈椎间盘疾病、疼痛管理、经皮硬膜外神经松解术、松解粘连、临床过程。
