Sencan Savas, Yolcu Gunay, Bilim Serhad, Kenis-Coskun Ozge, Gunduz Osman Hakan
Division of Pain Medicine, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Marmara University, Istanbul, Turkey.
Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Marmara University, Istanbul, Turkey.
Korean J Pain. 2022 Jan 1;35(1):106-113. doi: 10.3344/kjp.2022.35.1.106.
Coccygodynia is one of the chronic, refractory painful musculoskeletal disorders. Interventional procedures are applied to patients unresponsive to initial treatment in coccygodynia. This study aims to compare the treatment outcomes of ganglion impar block (GIB) and caudal epidural steroid injection (CESI) in patients with chronic coccygodynia.
This study was a prospective randomized comparison study conducted between June 2019 and January 2021. Patients diagnosed with chronic coccygodynia were randomly divided into two groups: the GIB group and the CESI group. The severity of pain, presence of neuropathic pain, and quality of life were evaluated using the Numeric Rating Scale, Leeds Assessment of the Neuropathic Symptoms and Signs Scale, and Short Form-12 Health Survey (SF-12), respectively.
A total of 34 patients in each group were included in the final analyses. While there was a significant decrease in pain intensity in both groups in the 3-month follow-up, this decrease was more significant in the GIB group at the 3rd week. There was a significant improvement in the SF-12 physical score and the number of patients with neuropathic pain in both groups in the 3rd week, but this improvement was not observed in the 3rd month.
Although GIB may provide more pain relief in short term, both GIB and CESI are useful treatment methods in coccygodynia unresponsive to more conservative treatments.
尾骨痛是一种慢性、难治性的肌肉骨骼疼痛疾病。对于尾骨痛初始治疗无反应的患者,会采用介入治疗方法。本研究旨在比较阴部神经节阻滞(GIB)和骶管硬膜外类固醇注射(CESI)对慢性尾骨痛患者的治疗效果。
本研究是一项于2019年6月至2021年1月进行的前瞻性随机对照研究。被诊断为慢性尾骨痛的患者被随机分为两组:GIB组和CESI组。分别使用数字评定量表、利兹神经病理性症状和体征评估量表以及简短健康调查问卷(SF - 12)评估疼痛严重程度、神经病理性疼痛的存在情况和生活质量。
每组各有34例患者纳入最终分析。在3个月的随访中,两组的疼痛强度均显著降低,但在第3周时,GIB组的疼痛强度降低更为显著。在第3周时,两组的SF - 12身体评分和神经病理性疼痛患者数量均有显著改善,但在第3个月时未观察到这种改善。
尽管GIB在短期内可能提供更多的疼痛缓解,但对于对更保守治疗无反应的尾骨痛患者,GIB和CESI都是有效的治疗方法。