腰椎手术失败综合征：一种通过硬膜外注射美司钠的新策略。
Failed back surgery syndrome: a new strategy by the epidural injection of MESNA.
作者信息
Carassiti M, Di Martino A, Centonze A, Quattrocchi C C, Caldaria A, Agrò F, Denaro V
机构信息
Department of Anesthesiology, Resuscitation and Pain Medicine, CIR - Center of Integrated Research, University Campus Bio-Medico of Rome, Rome, Italy.
Department of Orthopaedics and Trauma Surgery, CIR - Center of Integrated Research, University Campus Bio-Medico of Rome, Rome, Italy.
出版信息
Musculoskelet Surg. 2018 Aug;102(2):179-184. doi: 10.1007/s12306-017-0520-x. Epub 2017 Nov 2.
PURPOSE
Evaluate the efficacy and safety of MESNA (sodium 2-mercaptoethanesulfonate) injection into the epidural space in the FBSS.
METHODS
We designed a prospective phase II longitudinal study. Six consecutive patients were enrolled. Patients underwent one peridural injection per week for 3 weeks. NRS and ODI were investigated before and 48 h after injections, and at 1 week, 1 month and 2 months after the last procedures. Opioids intake is investigated before procedures and 1 week, 1 month and 3 months after the last procedures. Lumbosacral MRI is performed before the first procedure, at the end and 3 months after the last procedures.
RESULTS
From baseline, at 3 months, NRS in standing, sitting and lying position improved, respectively, of 34.29, 30.56 and 26.47%; ODI improved of 20.3%; the average decrease in morphine intake was 20.54%. No difference in MR images was found. Conclusions Our preliminary results suggest that MESNA might be an efficacy alternative to common practice.
目的
评估美司钠（2-巯基乙烷磺酸钠）硬膜外注射治疗失败的脊柱手术综合征（FBSS）的疗效和安全性。
方法
我们设计了一项前瞻性II期纵向研究。连续纳入6例患者。患者每周接受1次硬膜外注射，共3周。在注射前、注射后48小时以及最后一次操作后1周、1个月和2个月时调查数字疼痛评分量表（NRS）和腰椎功能障碍指数（ODI）。在操作前以及最后一次操作后1周、1个月和3个月时调查阿片类药物的摄入量。在第一次操作前、最后一次操作结束时以及最后一次操作后3个月时进行腰骶部磁共振成像（MRI）检查。
结果
从基线开始，在3个月时，站立位、坐位和卧位的NRS分别改善了34.29%、30.56%和26.47%；ODI改善了20.3%；吗啡摄入量平均减少了20.54%。MRI图像未发现差异。结论：我们的初步结果表明，美司钠可能是一种有效的常规替代方法。
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