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根据腰椎间盘突出症的位置、类型和大小,经椎间孔硬膜外类固醇注射治疗腰骶神经根性疼痛患者的长期疗效。

Long-term outcomes of transforaminal epidural steroid injection in patients with lumbosacral radicular pain according to the location, type, and size of herniated lumbar disc.

作者信息

Kwak Soyoung, Jang Seung Hwa, Chang Min Cheol

机构信息

Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Korea.

出版信息

Pain Pract. 2021 Nov;21(8):836-842. doi: 10.1111/papr.13029. Epub 2021 May 26.

DOI:10.1111/papr.13029
PMID:33973363
Abstract

OBJECTIVES

Transforaminal epidural steroid injection (TFESI) is widely used to manage lumbosacral radicular pain due to herniated lumbar disc (HLD).

OBJECTIVES

We evaluated the long-term outcomes of TFESI in patients with lumbosacral radicular pain due to an HLD by the location, type, and size of the HLD.

METHODS

In total, 114 patients who received the initial TFESI at least 4 years ago completed a telephone interview. We investigated the presence of radicular pain, degree of current pain, current pain medications and TFESIs, additional TFESIs, progression to surgery, and trouble in performing daily life activities and occupational job duties. We classified the included patients by the location, type, and size of the HLD, and evaluated whether these factors affected the long-term outcomes of TFESI.

RESULTS

At least 4 years after the initial TFESI, radicular pain was completely resolved in 45% of the patients. However, 30% patients were on oral painkillers or repetitive TFESIs or had undergone surgery and 15% had difficulty in performing daily life activities and occupational job duties. A larger number of patients with extruded lumbar disc herniation required additional TFESIs than those with protruded lumbar disc herniation. Apart from this, the outcomes did not significantly differ by the location, type, and size of the HLD.

CONCLUSIONS

Our findings provide useful information to clinicians managing radicular pain due to HLD.

摘要

目的

经椎间孔硬膜外类固醇注射(TFESI)被广泛用于治疗因腰椎间盘突出症(HLD)引起的腰骶神经根性疼痛。

目的

我们根据HLD的位置、类型和大小,评估了TFESI治疗因HLD导致腰骶神经根性疼痛患者的长期疗效。

方法

共有114名至少在4年前接受首次TFESI治疗的患者完成了电话访谈。我们调查了神经根性疼痛的存在情况、当前疼痛程度、当前使用的止痛药物和TFESI治疗情况、额外的TFESI治疗、是否进展为手术治疗以及日常生活活动和工作职责方面的困难。我们根据HLD的位置、类型和大小对纳入患者进行分类,并评估这些因素是否影响TFESI的长期疗效。

结果

在首次TFESI治疗至少4年后,45%的患者神经根性疼痛完全缓解。然而,30%的患者仍在服用口服止痛药或接受重复的TFESI治疗或已接受手术治疗,15%的患者在日常生活活动和工作职责方面存在困难。与腰椎间盘膨出症患者相比,腰椎间盘脱出症患者需要额外TFESI治疗的人数更多。除此之外,HLD的位置、类型和大小对疗效没有显著差异。

结论

我们的研究结果为治疗因HLD导致神经根性疼痛的临床医生提供了有用信息。

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