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预测在腰椎手术失败综合征中使用可操纵导管进行粘连松解术成功的因素:一项回顾性研究

Factors Predicting the Success of Adhesiolysis Using a Steerable Catheter in Lumbar Failed Back Surgery Syndrome: A Retrospective Study.

作者信息

Kim Ji Yeong, Lee Yong Ho, Yoo Subin, Kim Ji Young, Joo Mina, Park Hue Jung

机构信息

Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea.

出版信息

J Clin Med. 2021 Feb 26;10(5):913. doi: 10.3390/jcm10050913.

Abstract

Failed back surgery syndrome (FBSS) is a commonly encountered disease after lumbar surgery. There are many cases where it is difficult to choose a treatment because no specific cause can be found. Nevertheless, according to recent reports, adhesiolysis has shown reasonable evidence. However, considering its poor cost-effectiveness, adhesiolysis cannot be used as the first line of treatment. FBSS patients often suffer from chronic pain; accordingly, they become frustrated when this treatment produces a poor response. Therefore, before the procedure, the target group must be selected carefully. We sought to identify the pre-procedure factors predicting the effect of adhesiolysis in FBSS. A total of 150 patients were evaluated and analyzed retrospectively. Of these 150 patients, 69 were classified as responders three months after the procedure (46%). The outer diameter of the catheter during the procedure and grade of foraminal stenosis were correlated with the procedure effect. In conclusion, of the 2.1 mm diameter of the catheter, 1.7 mm of it was used during the procedure, and the milder the foraminal stenosis, the greater the pain reduction effect was three months after the procedure.

摘要

腰椎手术失败综合征(FBSS)是腰椎手术后常见的疾病。在许多病例中,由于找不到具体病因,治疗方案难以抉择。然而,根据最近的报道,粘连松解术已显示出合理的证据。然而,考虑到其成本效益不佳,粘连松解术不能作为一线治疗方法。FBSS患者常遭受慢性疼痛;因此,当这种治疗效果不佳时,他们会感到沮丧。所以,在手术前,必须仔细选择目标群体。我们试图确定预测FBSS粘连松解术效果的术前因素。总共对150例患者进行了回顾性评估和分析。在这150例患者中,69例在术后三个月被归类为有反应者(46%)。手术过程中导管的外径和椎间孔狭窄程度与手术效果相关。总之,导管直径为2.1mm,手术中使用1.7mm,椎间孔狭窄越轻,术后三个月疼痛减轻效果越大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0374/7956797/7cba0b036a58/jcm-10-00913-g001.jpg

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