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27 例颈枕部带状疱疹后神经痛患者行 CT 引导下颈椎背根神经节射频消融术。

Computed Tomography-Guided Radiofrequency Ablation of the Cervical Dorsal Root Ganglia in 27 Patients with Cervical and Occipital Postherpetic Neuralgia.

机构信息

Department of Anesthesiology and Pain Medical Center, First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China (mainland).

Department of Anesthesiology and Pain Medical Center, First Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, China (mainland).

出版信息

Med Sci Monit. 2021 Oct 16;27:e932612. doi: 10.12659/MSM.932612.

Abstract

BACKGROUND Postherpetic neuralgia (PHN) is a common complication of herpes zoster virus infection that is associated with intense pain. The present study aimed to investigate the use of computed tomography (CT)-guided radiofrequency ablation (RFA) of the cervical dorsal root ganglia (DRG) for treatment of cervical and occipital PHN in 27 patients at a single center. MATERIAL AND METHODS Twenty-seven patients with PHN in the cervical and/or occipital region were enrolled. After imaging the area of PHN in the patients, axial scanning was performed on the upper cervical segment in the spinal scanning mode. The puncture path was defined and then RFA therapy (90°C for 180 s) was performed by targeting the corresponding intervertebral foramen. Patients were followed 2 days later and at 1, 3, 6, and 12 months after surgery. Observation at each follow-up visit included rating of pain on a visual analog scale (VAS) and assessment of complications and adverse events. RESULTS VAS scores significantly decreased in patients with PHN after RFA compared with their scores before RFA (P<0.05). Skin sensation decreased in the area that was originally painful and allodynia significantly diminished. CONCLUSIONS The findings from this small study from a single center showed that CT-guided percutaneous RFA of cervical DRG safely and effectively reduced cervical and occipital PHN in the short term.

摘要

背景

带状疱疹后神经痛(PHN)是带状疱疹病毒感染的常见并发症,与剧烈疼痛有关。本研究旨在探讨 CT 引导下颈椎背根神经节(DRG)射频消融(RFA)治疗 27 例单中心颈枕部 PHN 的效果。

材料与方法

共纳入 27 例颈枕部 PHN 患者。在对患者 PHN 区域进行影像学检查后,在脊柱扫描模式下对颈椎上段进行轴向扫描。确定穿刺路径后,通过靶向相应椎间孔对相应节段进行 RFA 治疗(90°C 持续 180s)。术后第 2 天及术后 1、3、6、12 个月对患者进行随访。每次随访时观察视觉模拟评分(VAS)评定疼痛程度,评估并发症和不良反应。

结果

与 RFA 前相比,RFA 后 PHN 患者的 VAS 评分明显降低(P<0.05)。原本疼痛区域的皮肤感觉下降,痛觉过敏明显减轻。

结论

本研究为单中心小样本研究结果显示,CT 引导下经皮颈椎 DRG RFA 可安全有效地减轻颈枕部 PHN,短期疗效显著。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5cf/8527873/37b55fc8855d/medscimonit-27-e932612-g001.jpg

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