Sencan Savas, Cuce Isa, Karabiyik Ozgur, Demir Fatmagul U, Ercalik Tulay, Gunduz Osman H
1 Department of Physical Medicine and Rehabilitation, Division of Pain Medicine, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey.
2 Department of Physical Medicine and Rehabilitation, Adiyaman University Training and Research Hospital, Adiyaman, Turkey.
Interv Neuroradiol. 2018 Oct;24(5):580-585. doi: 10.1177/1591019918781673. Epub 2018 Jul 3.
Objective Ganglion impar block (GIB) can be performed in patients with chronic coccygodynia who do not respond to conservative treatments. We investigated the effect of coccygeal dynamic patterns on the treatment outcome in patients with chronic coccygodynia treated with GIB. Materials and methods We retrospectively analyzed the data for patients diagnosed with chronic coccygodynia who underwent GIB only once by a transsacrococcygeal method under fluoroscopy guidance in our Pain Medicine Clinic. Patients were assessed with standard and dynamic coccyx radiographs and classified according to coccygeal mobility. Pain scores were assessed with a numerical rating scale (NRS) before and after the intervention (at 1 hour and 4, 12 and 24 weeks). A 50% or more reduction in the NRS score was accepted as significant pain relief. Results Of the 37 patients included in the study, 14 had normal coccyx (Group I) and 23 had immobile coccyx (Group II) based on the radiological evaluation. The NRS scores were significantly reduced in both groups on each follow-up visit but there was no significant difference between the two groups in terms of pre- and post-intervention NRS scores. Significant pain relief was achieved in 42.9% and 61.9% of patients in Group I and II at the last examination, respectively. Conclusion GIB administered by transsacrococcygeal method in patients with chronic coccygodynia is a safe and alternative treatment approach with reduced pain scores and low complication rates. In patients with chronic coccygodynia, having a normal or immobile coccyx does not appear to affect treatment outcomes.
目的 对于保守治疗无效的慢性尾骨痛患者，可实施奇神经节阻滞（GIB）。我们研究了尾骨动态模式对接受GIB治疗的慢性尾骨痛患者治疗效果的影响。材料与方法 我们回顾性分析了在我们疼痛医学门诊接受过一次经骶尾法荧光透视引导下GIB治疗的慢性尾骨痛患者的数据。患者接受标准和动态尾骨X线片检查，并根据尾骨活动度进行分类。在干预前（1小时）和干预后4周、12周及24周，使用数字评定量表（NRS）评估疼痛评分。NRS评分降低50%或更多被视为疼痛显著缓解。结果 根据影像学评估，纳入研究的37例患者中，14例尾骨正常（I组），23例尾骨固定（II组）。两组在每次随访时NRS评分均显著降低，但两组干预前后NRS评分无显著差异。在最后一次检查时，I组和II组分别有42.9%和61.9%的患者疼痛显著缓解。结论 经骶尾法对慢性尾骨痛患者实施GIB是一种安全的替代治疗方法，可降低疼痛评分且并发症发生率低。对于慢性尾骨痛患者，尾骨正常或固定似乎不影响治疗效果。
