Department of Physical Medicine and Rehabilitation, University of Missouri, Columbia, MO.
Kansas City Orthopedic Alliance, Leawood, KS.
Curr Sports Med Rep. 2022 Sep 1;21(9):328-335. doi: 10.1249/JSR.0000000000000991.
This study analyzes the effectiveness of ultrasound-guided hydrodissection (HD) perineural as a treatment for radial tunnel syndrome (RTS). A literature search was performed along with retrospective analysis of local cases to assess outcomes and safety of this procedure. In the case series, surgical candidates, defined as cases with over 80% but temporary relief after diagnostic injection, were treated with ultrasound-guided HD. Of 22 patients who received ultrasound-guided diagnostic injections, 11 proceeded to HD. All HD patients experienced complete and lasting symptom resolution for a minimum of 2 years, and none required surgery. Thorough literature review provided seven studies, which fulfilled inclusion criteria. Sixty-one patients are represented in the literature. All studies reported significant benefit to pain symptoms with HD of radial nerve, with five specifying over 90% improvement. No adverse effects from HD were noted in any study. Ultrasound-guided HD of the radial tunnel has potential to be a surgery sparing treatment for RTS.
本研究分析了超声引导下水分离(HD)在治疗桡管综合征(RTS)中的效果。通过文献检索和局部病例回顾性分析,评估了该手术的疗效和安全性。在病例系列中,将手术候选者(定义为经诊断性注射后缓解超过 80%但为暂时缓解的患者)进行超声引导下 HD 治疗。在接受超声引导诊断性注射的 22 名患者中,有 11 名进行了 HD 治疗。所有接受 HD 治疗的患者均至少 2 年完全缓解且症状持续缓解,无一例需要手术。全面的文献复习提供了 7 项符合纳入标准的研究,其中共涉及 61 名患者。所有研究均报告了 HD 对桡神经疼痛症状有显著益处,其中 5 项研究表明疼痛改善超过 90%。在任何研究中均未发现 HD 有不良反应。超声引导下桡管 HD 治疗桡管综合征具有作为一种保留手术治疗的潜力。