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无菌水机械针刺与利多卡因注射治疗腰椎管狭窄症的比较

Mechanical Needling With Sterile Water Versus Lidocaine Injection for Lumbar Spinal Stenosis.

作者信息

Suputtitada Areerat, Chen Carl P C, Pongpirul Krit

机构信息

Department of Rehabilitation Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.

Department of Physical Medicine & Rehabilitation, Chang Gung Memorial Hospital at Linkou, College of Medicine,Chang Gung University, Taoyuan, Taiwan.

出版信息

Global Spine J. 2024 Jan;14(1):82-92. doi: 10.1177/21925682221094533. Epub 2022 May 4.

Abstract

This was a retrospective observational study that assessed the clinical outcome of ageing patients who received ultrasound-guided (USG) mechanical needling with sterile water injection. In addition, the clinical outcome of age-and gender matched patients randomly selected from patients who received needling with sterile water was compared to the patients injected with lidocaine in a 1:1 ratio. This present study aimed to explore the clinical effects of USG mechanical needling with sterile water injection for lumbar spinal stenosis (LSS). The data was extracted from the medical records of ageing patients with LSS who received USG injection at the lumbosacral spine by the first author. Low back pain or axial pain, and leg pain or radicular pain were assessed by the visual analogue scale, and gait ability with walking distance were obtained at six different time points. A total of 4328 medical records were examined. Four thousand two hundred and twenty-eight ageing patients received mechanical needling with sterile water injection and found the efficacy lasted up to 6 months. One hundred patients were compared with 100 patients who received lidocaine injection. Those who received lidocaine had pain returned at 3 months and 6 months post-injection. USG mechanical needling with sterile water injection could help relieve axial and radicular pain for at least 6 months. Removal of calcification and fibrosis as well as reduction of sensitization are all possible mechanisms.

摘要

这是一项回顾性观察研究,评估了接受超声引导(USG)下无菌水注射机械针刺的老年患者的临床结局。此外,从接受无菌水针刺的患者中随机选取年龄和性别匹配的患者,与接受利多卡因注射的患者按1:1比例进行临床结局比较。本研究旨在探讨超声引导下无菌水注射机械针刺治疗腰椎管狭窄症(LSS)的临床效果。数据由第一作者从接受腰骶部超声引导注射的老年LSS患者的病历中提取。通过视觉模拟量表评估腰背痛或轴性疼痛以及腿痛或神经根性疼痛,并在六个不同时间点获得步行距离的步态能力。共检查了4328份病历。4228例老年患者接受了无菌水注射机械针刺,发现疗效可持续6个月。将100例患者与100例接受利多卡因注射的患者进行比较。接受利多卡因注射的患者在注射后3个月和6个月疼痛复发。超声引导下无菌水注射机械针刺可帮助缓解轴性和神经根性疼痛至少6个月。去除钙化和纤维化以及减轻敏化都是可能的机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/862a/10676179/8e24c164cd0f/10.1177_21925682221094533-fig1.jpg

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