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根据颈椎椎间孔狭窄严重程度进行经椎间孔硬膜外类固醇注射的结果

Outcome of Transforaminal Epidural Steroid Injection According to Severity of Cervical Foraminal Stenosis.

作者信息

Kim Min Son, Lee Dong Gyu, Chang Min Cheol

机构信息

Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Taegu, Republic of Korea.

Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Taegu, Republic of Korea.

出版信息

World Neurosurg. 2018 Feb;110:e398-e403. doi: 10.1016/j.wneu.2017.11.014. Epub 2017 Nov 11.

Abstract

BACKGROUND

Cervical transforaminal epidural steroid injection (TFESI) is considered one of the most effective treatments for radicular pain induced by cervical foraminal stenosis.

PURPOSE AND DESIGN

We sought to evaluate the treatment outcome of TFESI according to the severity of cervical foraminal stenosis. In our retrospective study there were 53 patients with cervical radiculopathy due to cervical foraminal stenosis.

OUTCOME MEASURES

Pain intensity was evaluated using a numeric rating scale (NRS) at pretreatment, 2 weeks, and 1, 2, and 3 months after TFESI.

METHODS

Patients were divided into 2 groups according to the severity of stenosis by cervical axial magnetic resonance imaging findings. Twenty-two patients were assigned to group A (nonsevere stenosis), and 31 patients were assigned to group B (severe stenosis).

RESULTS

Thirty-seven (69.8%) of 53 patients showed successful treatment outcome (>50% reduction in the NRS score at 3 months). The patients in both groups showed a significant decrease in NRS scores at 2 weeks and at 1, 2, and 3 months after TFESI. However, the effect of TFESI was not significantly different between patients with nonsevere cervical foraminal stenosis and those with severe cervical foraminal stenosis.

CONCLUSIONS

The treatment outcome of cervical TFESI did not different according to the severity of cervical foraminal stenosis. However, on the basis of our results, we suggest that TFESI can be a beneficial clinical option for managing radicular pain due to cervical foraminal stenosis.

摘要

背景

颈椎经椎间孔硬膜外类固醇注射(TFESI)被认为是治疗颈椎椎间孔狭窄引起的根性疼痛最有效的方法之一。

目的与设计

我们试图根据颈椎椎间孔狭窄的严重程度评估TFESI的治疗效果。在我们的回顾性研究中,有53例因颈椎椎间孔狭窄导致神经根病的患者。

观察指标

在TFESI治疗前、治疗后2周以及治疗后1、2和3个月,使用数字评分量表(NRS)评估疼痛强度。

方法

根据颈椎轴向磁共振成像结果显示的狭窄严重程度将患者分为两组。22例患者被分配到A组(非严重狭窄),31例患者被分配到B组(严重狭窄)。

结果

53例患者中有37例(69.8%)显示治疗成功(3个月时NRS评分降低>50%)。两组患者在TFESI治疗后2周以及治疗后1、2和3个月时NRS评分均显著降低。然而,非严重颈椎椎间孔狭窄患者与严重颈椎椎间孔狭窄患者之间TFESI的效果无显著差异。

结论

颈椎TFESI的治疗效果不因颈椎椎间孔狭窄的严重程度而有所不同。然而,基于我们的研究结果,我们认为TFESI可能是治疗颈椎椎间孔狭窄引起的根性疼痛的一种有益的临床选择。

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