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小关节突关节注射对伴神经根病的腰椎管狭窄症的影响。

The effect of facet joint injection on lumbar spinal stenosis with radiculopathy.

作者信息

Park Chan Jin, Shin Young Duck, Lim Seung Woon, Bae Yoo Mee

机构信息

Chan Jin Park, MD. Department of Anesthesiology and Pain Medicine, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Korea.

Prof. Dr. Young Duck Shin, MD, PhD. Department of Anesthesiology and Pain Medicine, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Korea.

出版信息

Pak J Med Sci. 2018 Jul-Aug;34(4):968-973. doi: 10.12669/pjms.344.15010.

Abstract

OBJECTIVES

Facet Joint Injection (FJI) is known to be effective in axial back pain, but the purpose of this study was to assess the effects of FJI on patients treated with it among those with Lumbar Spinal Stenosis (LSS).

METHODS

We conducted a retrospective database analysis and investigated electronic medical records of 125 LSS patients treated with FJI in the pain clinic of Chungbuk National University Hospital from November 2, 2016 to July 31, 2017. Sex, age, histories of low back surgery, complaining of neurogenic claudication, symptomatic sites of patients, FJI sites, number of sites of FJI, triamcinolone dosage, Numeric Rating Scale (NRS) before and after treatment, facet joint capsule rupture during treatment, and improvement of neurogenic claudication after treatment, were examined.

RESULTS

Among 125 patients, we investigated 91 patients who met the criteria. There was significant difference in NRS before and after treatment (p<0.000). Forty one patients with reduction of NRS more than 30% after FJI were allocated to effect group. FJI was more effective in patients who did not have the surgery (p=0.044), as well as those who showed an improved neurogenic claudication after treatment (p=0.001). Other measured values did not show statistical significances.

CONCLUSIONS

FJI has relatively a lower risk and is simpler in terms of techniques than other interventional treatments performed within the spinal canal. Therefore, FJI may be another interventional treatment option in patients with pain by LSS. In the future, studies for FJI indication in LSS patients should be additionally required.

摘要

目的

小关节突关节注射(FJI)已知对轴性背痛有效,但本研究的目的是评估FJI对腰椎管狭窄症(LSS)患者的治疗效果。

方法

我们进行了一项回顾性数据库分析,调查了2016年11月2日至2017年7月31日在忠北国立大学医院疼痛诊所接受FJI治疗的125例LSS患者的电子病历。检查了患者的性别、年龄、腰椎手术史、神经源性间歇性跛行主诉、症状部位、FJI部位、FJI部位数量、曲安奈德剂量、治疗前后的数字评分量表(NRS)、治疗期间小关节突关节囊破裂情况以及治疗后神经源性间歇性跛行的改善情况。

结果

在125例患者中,我们调查了符合标准的91例患者。治疗前后NRS有显著差异(p<0.000)。FJI后NRS降低超过30%的41例患者被分配到有效组。FJI对未接受手术的患者更有效(p=0.044),对治疗后神经源性间歇性跛行有所改善的患者也更有效(p=0.001)。其他测量值未显示统计学意义。

结论

与在椎管内进行的其他介入治疗相比,FJI风险相对较低且技术更简单。因此,FJI可能是LSS患者疼痛的另一种介入治疗选择。未来,还需要对LSS患者的FJI适应症进行研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4eda/6115579/31b2b3350176/PJMS-34-968-g001.jpg

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