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介入治疗复杂区域疼痛综合征。

Interventional Modalities to Treat Complex Regional Pain Syndrome.

机构信息

Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, AZ, USA.

Division of Pain Medicine, Department of Anesthesiology, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ, 85018, USA.

出版信息

Curr Pain Headache Rep. 2021 Feb 3;25(2):10. doi: 10.1007/s11916-020-00904-5.

Abstract

PURPOSE OF REVIEW

Complex regional pain syndrome (CRPS) is a debilitating pain condition that often requires a multidisciplinary approach including medication, physical therapy, occupational therapy, psychological therapy, and interventional procedures to restore the patient's quality of life. This article reviews the interventional treatments for pain resulting from CRPS.

RECENT FINDINGS

Sympathetic nerve blocks (stellate ganglion and lumbar sympathetic) are the first-line interventional treatment options for patients with CRPS of the upper and lower extremities, respectively. Fluoroscopic techniques for lumbar sympathetic blocks have not significantly changed throughout the years. However, both novel fluoroscopic and ultrasound approaches to stellate ganglion blockade have arisen. In addition, novel neuromodulation therapies to treat CRPS have been developed to include new waveforms with dorsal column stimulation and entirely new nerve targets such as dorsal root ganglion stimulation. This paper will review the latest interventional treatment options available for the treatment of CRPS.

摘要

目的综述

复杂性区域疼痛综合征(CRPS)是一种使人虚弱的疼痛病症,常需要多学科方法治疗,包括药物治疗、物理治疗、职业治疗、心理治疗和介入性操作,以恢复患者的生活质量。本文综述了用于治疗 CRPS 所致疼痛的介入性治疗。

最近的发现

星状神经节阻滞(颈胸神经节和腰交感神经阻滞)分别为上肢和下肢 CRPS 的一线介入治疗选择。多年来,腰椎交感神经阻滞的荧光镜技术并未显著改变。然而,新的荧光镜和超声方法已经出现用于星状神经节阻滞。此外,新的神经调节疗法也已开发出来用于治疗 CRPS,包括新的波形的后柱刺激和全新的神经靶点,如背根神经节刺激。本文将综述目前可用于治疗 CRPS 的最新介入性治疗选择。

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