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超声与传统荧光透视引导下骶管硬膜外注射治疗慢性下腰痛的比较

Comparison of Ultrasonography and Conventional Fluoroscopy Guided Caudal Epidural Injection in Chronic Low Back Pain.

作者信息

Senkal Serkan, Sir Ender

机构信息

University of Health Sciences, Gulhane Medical Faculty, Department of Anesthesiology and Reanimation, Ankara, Turkey.

出版信息

Turk Neurosurg. 2021;31(1):119-123. doi: 10.5137/1019-5149.JTN.31515-20.2.

Abstract

AIM

To compare the efficacies of fluoroscopy- and ultrasound (US)-guided caudal epidural steroid injections (CESIs) in patients with chronic low back pain (LBP).

MATERIAL AND METHODS

This study included patients with chronic LBP who underwent US- (Group U; n = 90) or fluoroscopyguided (Group F; n = 90) CESI. The procedure time, successful injection rate on the first attempt, complication rate, Oswestry Disability Index (ODI) score, and Numeric Rating Scale (NRS) score before CESI and after 3 weeks and 3 months of CESI were analyzed.

RESULTS

NRS and ODI scores improved at 3 weeks (p < 0.001) and 3 months (p < 0.001) after CESIs. No significant differences were noted between the two groups for the NRS (p=0.22 and p=0.47) and ODI (p=0.58, p=0.22) scores. Moreover, the CESI procedure time was significantly shorter (p < 0.001) and the successful injection rate on the first attempt was significantly higher (p=0.002) in Group U than in Group F. The complication rate difference was statistically insignificant between the two groups (p > 0.05).

CONCLUSION

Outcomes of US-guided CESI were superior than those of fluoroscopy-guided CESI considering the successful injection rate on the first attempt and procedure time. In addition, US-guided CESI was as effective as fluoroscopy-guided CESI and did not expose patients and practitioners to radiation.

摘要

目的

比较荧光透视引导和超声引导下的骶管硬膜外类固醇注射(CESI)对慢性下腰痛(LBP)患者的疗效。

材料与方法

本研究纳入了接受超声引导(U组;n = 90)或荧光透视引导(F组;n = 90)CESI的慢性LBP患者。分析了操作时间、首次注射成功率、并发症发生率、Oswestry功能障碍指数(ODI)评分以及CESI前、CESI后3周和3个月时的数字评分量表(NRS)评分。

结果

CESI后3周(p < 0.001)和3个月(p < 0.001)时,NRS和ODI评分改善。两组的NRS评分(p = 0.22和p = 0.47)和ODI评分(p = 0.58,p = 0.22)无显著差异。此外,U组的CESI操作时间明显更短(p < 0.001),首次注射成功率明显更高(p = 0.002),高于F组。两组并发症发生率差异无统计学意义(p > 0.05)。

结论

考虑到首次注射成功率和操作时间,超声引导下的CESI效果优于荧光透视引导下的CESI。此外,超声引导下的CESI与荧光透视引导下的CESI效果相同,且不会使患者和操作者暴露于辐射中。

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