Jönsson B, Strömqvist B, Annertz M, Holtås S, Sundén G
Department of Orthopaedics and Diagnostic Radiology, University Hospital, Lund, Sweden.
J Spinal Disord. 1988;1(3):232-5.
Lumbar nerve root anesthesia using a local anesthetic was performed in 100 cases of sciatica. The neurological state before and after nerve block was recorded and also the degree of pain alleviation caused by the block. Three indications for the block were used in the study: unilateral sciatic pain and normal findings on myelography and/or CT or MR (n = 51), minor myelographic findings that possibly but not necessarily explained the patient's symptom (n = 40), and multiple pathological findings on myelography (n = 9). In 87% of the patients, the nerve block inflicted temporary sensory and/or motor disturbance within the dermatome anesthesized. In total, 51% experienced total, 31 partial, and 18 no pain relief after injection. No side effects of the procedure were noted. Patients with pain alleviation after anesthesia were offered an operative nerve root decompression and short-term results of this decompression seem to be comparable to conventional disc surgery. Anesthetizing the lumbar nerve root outside the intervertebral foramen may be considered in the preoperative evaluation of patients with sciatic pain and minor or no radiographic findings.
对100例坐骨神经痛患者实施了使用局部麻醉剂的腰神经根麻醉。记录了神经阻滞前后的神经状态以及阻滞引起的疼痛缓解程度。本研究采用了三种阻滞指征：单侧坐骨神经痛且脊髓造影和/或CT或MR检查结果正常（n = 51）、脊髓造影有轻微异常发现但不一定能解释患者症状（n = 40）、脊髓造影有多处病理发现（n = 9）。87%的患者在麻醉皮节内出现了暂时性感觉和/或运动障碍。注射后，总计51%的患者疼痛完全缓解，31%部分缓解，18%未缓解。未观察到该操作的副作用。麻醉后疼痛缓解的患者接受了手术神经根减压，该减压的短期效果似乎与传统椎间盘手术相当。对于坐骨神经痛且影像学检查轻微异常或无异常发现的患者，在术前评估时可考虑椎间孔外腰神经根麻醉。
