Pain Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
Department of Anesthesiology and Critical Care, Imam Khomeini Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Sci Rep. 2022 Apr 8;12(1):5954. doi: 10.1038/s41598-022-10021-5.
Transforaminal epidural block (TEB) is a widely accepted technique and minimally invasive procedure for the treatment of lumbosacral radicular pain. This study aimed to evaluate the accuracy, efficacy, and safety of ultrasound and nerve stimulator guidance lumbar transforaminal epidural block (UNTEB) for the patients with unilateral lower lumbar radicular pain. The accuracy of this method was evaluated by fluoroscopy. Using UNTEB via axial and the in-plane approach technique was performed in 42 segments of 25 patients who presented with lumbosacral radicular pain to lower extremities. The contrast medium was injected to evaluate the needle tip at the intervertebral foramen under fluoroscopic guidance. The numerical rating scale was used to assess pain before and after treatment. The success ratio of UNTEB in L3/L4 level was 100%, in L4/L5 was 95.4% and in L5/S1 was 100%. The numerical rating scale (NRS) for lumbosacral radicular pain improved from a mean from 7.8 to 2.8 1 day after procedure (p = 0.01) and from a mean from 7.8 to 2.4 1 week after UNTEB (p = 0.01). None of our subjects experienced any complications during and after the procedure. UNTEB with fluoroscopic validation is an accurate, effective, and safe method for short-term pain relief of the patients with unilateral lumbosacral radicular pain.
经椎间孔硬膜外阻滞（TEB）是治疗腰骶神经根痛的一种广泛认可的技术和微创方法。本研究旨在评估超声和神经刺激器引导下腰椎经椎间孔硬膜外阻滞（UNTEB）治疗单侧下腰痛的准确性、疗效和安全性。该方法的准确性通过透视检查进行评估。通过轴向和平面内技术对 25 例单侧下肢根性痛患者的 42 个节段进行 UNTEB。在透视引导下，将造影剂注入以评估针尖在椎间孔处的位置。采用数字评分量表评估治疗前后的疼痛。UNTEB 在 L3/L4 水平的成功率为 100%，在 L4/L5 水平为 95.4%，在 L5/S1 水平为 100%。腰骶神经根痛的数字评分量表（NRS）从治疗后 1 天的平均 7.8 分降至 2.8 分（p=0.01），从治疗后 1 周的平均 7.8 分降至 2.4 分（p=0.01）。我们的所有患者在手术过程中和手术后均未出现任何并发症。UNTEB 联合透视验证是一种准确、有效、安全的方法，可在短期内缓解单侧腰骶神经根痛患者的疼痛。
