Liang Cheng-Loong, Wang Shih-Wei, Chen Han-Jung, Tsai Yu-Duan, Chen Jui-Sheng, Wang Hao-Kuang, Wang Kuo-Wei
Department of Neurosurgery, E-DA Hospital, Kaohsiung, Taiwan.
School of Medicine, I-Shou University, Kaohsiung, Taiwan.
J Pain Res. 2021 Jun 28;14:1949-1957. doi: 10.2147/JPR.S303979. eCollection 2021.
After proper patient selection, anatomically correct pulsed radiofrequency of the lumbar facet joints provide long-term pain relief in a routine clinical setting. In the study, we performed an analysis of clinical and radiological predictive factors and provide the scientific basis for this promising modality.
The study included 198 patients with lower back pain due to lumbar facet joint disease who underwent medial branch block and pulsed radiofrequency during the period 2015-2019. According to the improvement in pain score, the patients were divided into good and poor outcome groups. Clinical and radiological data were collected and analyzed.
The multivariable analysis revealed the predictive factors, including lumbar lordosis, lower lumbar lordosis, pelvic tilt, the number of facet joints, old compression fracture with/without vertebroplasty, and post lumbar fusion procedures.
With the results of this study, we demonstrated that the improved outcome after the surgery was related to lumbar lordosis, lower lumbar lordosis, pelvic tilt, the number of facet joints, old compression fracture with/without vertebroplasty, and the lumbar fusion procedures. Old compression fractures and lumbar fusion would change the radiological factors and cause refractory lumbar facet joint pain.
在进行适当的患者选择后，腰椎小关节的解剖学正确的脉冲射频在常规临床环境中可提供长期疼痛缓解。在本研究中，我们对临床和放射学预测因素进行了分析，并为这种有前景的治疗方式提供科学依据。
该研究纳入了198例因腰椎小关节疾病导致下腰痛的患者，这些患者在2015年至2019年期间接受了内侧支阻滞和脉冲射频治疗。根据疼痛评分的改善情况，将患者分为预后良好组和预后不良组。收集并分析临床和放射学数据。
多变量分析揭示了预测因素，包括腰椎前凸、下腰椎前凸、骨盆倾斜、小关节数量、有/无椎体成形术的陈旧性压缩骨折以及腰椎后路融合手术。
根据本研究结果，我们证明手术后预后改善与腰椎前凸、下腰椎前凸、骨盆倾斜、小关节数量、有/无椎体成形术的陈旧性压缩骨折以及腰椎融合手术有关。陈旧性压缩骨折和腰椎融合会改变放射学因素并导致难治性腰椎小关节疼痛。
