Ma Danxu, Li Huili, Shi Rong, Yang Yinan, Liu Haoda, Ge Xiaodong
Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China.
Department of Anesthesiology, Beijing Huairou Maternal and Child Health Care Hospital, Beijing, People's Republic of China.
J Pain Res. 2020 Dec 8;13:3331-3336. doi: 10.2147/JPR.S280541. eCollection 2020.
Persistent or recurring radicular pain after lumbar surgery is a clinical condition of failed back surgery syndrome (FBSS) that seriously affects the life quality of patients. Conventional medication and physiotherapy do not fully relieve this pain. A simpler, safer, and less invasive option is lumbar selective nerve root block or paravertebral block. Here, we share our experience regarding lumbar paravertebral block for a patient with FBSS, which successfully alleviated radicular pain after lumbar surgery.
An 80-year-old man with left lower limb radicular pain diagnosed as L4-5, L5-S1 intervertebral disc protrusion, spinal canal stenosis, and degenerative scoliosis underwent lumbar surgery. Four months after surgery, he experienced left lower limb radicular pain. After designing the puncture route based on X-ray film, we performed a combined ultrasound-guided L4 and L5 paravertebral block. With his improved pain control, his functional status and ability to perform daily activities also markedly improved.
Real-time ultrasound-guided lumbar paravertebral block performed with a pre-designed route on X-ray film can provide a simple and safe way to relieve radicular pain in FBSS.
腰椎手术后持续或反复出现的神经根性疼痛是腰椎手术失败综合征（FBSS）的一种临床情况，严重影响患者的生活质量。传统药物治疗和物理治疗并不能完全缓解这种疼痛。一种更简单、更安全且侵入性更小的选择是腰椎选择性神经根阻滞或椎旁阻滞。在此，我们分享我们对一名FBSS患者进行腰椎椎旁阻滞的经验，该阻滞成功缓解了腰椎手术后的神经根性疼痛。
一名80岁男性，因左下肢神经根性疼痛被诊断为L4 - 5、L5 - S1椎间盘突出、椎管狭窄和退行性脊柱侧弯，接受了腰椎手术。术后4个月，他出现左下肢神经根性疼痛。在根据X线片设计穿刺路径后，我们进行了超声引导下L4和L5联合椎旁阻滞。随着疼痛得到改善，他的功能状态和日常活动能力也显著提高。
在X线片上预先设计路径，实时超声引导下进行腰椎椎旁阻滞可为缓解FBSS的神经根性疼痛提供一种简单且安全的方法。
