Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Department of Anesthesiology, Mount Sinai Medical Center of Florida, Miami, FL.
Pain Physician. 2021 Jan;24(1):E45-E50.
Twelfth rib syndrome, or slipping of the 12th rib, is an often overlooked cause for chronic chest, back, flank, and abdominal pain from irritation of the 12th intercostal nerve. Diagnosis is clinical and follows the exclusion of other causes of pain. This syndrome is usually accompanied by long-suffering, consequent psychiatric comorbidities, and increased health care costs, which are secondary to the delayed diagnosis.
This manuscript is a review of twelfth rib syndrome and its management options. The review provides etiology, pathophysiology, and epidemiology of twelfth rib syndrome. Additionally, diagnosis and current options for treatment and management are presented.
This is a narrative review of twelfth rib syndrome.
A database review.
A PubMed search was conducted to ascertain seminal literature regarding twelfth rib syndrome.
Conservative treatment is usually the first line, including local heat or ice packs, rest, and oral over-the-counter analgesics. Transcutaneous stimulation and 12th intercostal nerve cryotherapy have also been described with some success. Nerve blocks can additionally be tried and are usually effective in the immediate term; there is a paucity of evidence to suggest long-term efficacy. Surgical removal of all or part of the 12th rib and possibly the 11th rib, as well as the next line of therapy, may provide long-lasting relief of pain.
Further large scale clinical studies are needed to assess the most effective management of twelfth rib syndrome.
Twelfth rib syndrome is usually diagnosed late and causes significant morbidity and suffering. The actual epidemiology is unclear given the difficulty of diagnosis. Nerve blocks and surgical rib resection appear to be effective in treating this syndrome, however, further evidence is required to properly evaluate them. Familiarity with this syndrome is crucial in reaching a prompter diagnosis.
第十二肋骨综合征，又称第十二肋骨滑动，是一种常被忽视的慢性胸痛、背痛、侧腹痛和腹痛的原因，由第十二肋间神经受刺激引起。第十二肋骨综合征的诊断基于临床，遵循排除其他疼痛原因的原则。这种综合征通常伴随着长期的痛苦、随之而来的精神共病和增加的医疗保健费用，这是由于诊断延迟所致。
本文综述了第十二肋骨综合征及其治疗选择。综述提供了第十二肋骨综合征的病因、病理生理学和流行病学。此外，还介绍了第十二肋骨综合征的诊断和目前的治疗选择。
这是一篇关于第十二肋骨综合征的叙述性综述。
数据库综述。
通过 PubMed 检索，确定了关于第十二肋骨综合征的主要文献。
保守治疗通常是第一线治疗方法，包括局部热敷或冷敷、休息和口服非处方止痛药。经皮刺激和第十二肋间神经冷冻疗法也有一定的成功报道。神经阻滞也可以尝试，通常在短期内有效，但缺乏长期疗效的证据。手术切除全部或部分第十二肋骨和可能的第十一肋骨，以及下一线治疗，可能提供长期的疼痛缓解。
需要进一步的大规模临床研究来评估第十二肋骨综合征的最佳治疗方法。
第十二肋骨综合征通常诊断较晚，导致显著的发病率和痛苦。由于诊断困难，实际的流行病学情况尚不清楚。神经阻滞和手术肋骨切除似乎对治疗这种综合征有效，但需要进一步的证据来对其进行适当评估。熟悉这种综合征对于及时诊断至关重要。
