Kale Ahmet, Aytuluk Hande Gurbuz, Cam Isa, Basol Gulfem, Sunnetci Bahar
University of Health Sciences, Derince Training and Research Hospital, Department of Gynecology and Obstetrics, Kocaeli, Turkey.
Turk Neurosurg. 2019;29(4):530-237. doi: 10.5137/1019-5149.JTN.23990-18.1.
To seek the efficacy of selective spinal nerve blocks in the treatment of groin pain that are irresponsive to peripheral nerve blocks.
This retrospective study comprised 17 patients with ilioinguinal, iliohypogastric, and genitofemoral neuralgias treated between 2017 and 2018.
All patients received diagnostic peripheral nerve blocks and/or TAP blocks with blind or ultrasound-guided techniques. Four patients had ineffectual peripheral nerve blocks, after which they underwent T12 and L1 selective spinal nerve blocks. All four patients had satisfactory results.
If distal peripheral nerve blocks are ineffective, an upper level nerve lesion, a lesion in the lumbar plexus or an L1 radiculopathy should be considered in ilioinguinal, iliohypogastric, and genitofemoral neuralgias. Upper level nerve blocks should be performed before deciding on surgery.
探讨选择性脊神经阻滞治疗对周围神经阻滞无效的腹股沟区疼痛的疗效。
本回顾性研究纳入了2017年至2018年间接受治疗的17例髂腹股沟神经、髂腹下神经和生殖股神经痛患者。
所有患者均接受了诊断性周围神经阻滞和/或采用盲法或超声引导技术的腹横肌平面阻滞。4例患者周围神经阻滞无效，随后接受了T12和L1选择性脊神经阻滞。所有4例患者均取得了满意的效果。
如果远端周围神经阻滞无效，对于髂腹股沟神经、髂腹下神经和生殖股神经痛，应考虑高位神经病变、腰丛病变或L1神经根病。在决定手术之前应先进行高位神经阻滞。
