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超声引导与盲法尾骨皮质类固醇注射治疗慢性尾骨痛:一项随机临床试验

Ultrasound-Guided vs. Blind Coccygeal Corticosteroid Injections for Chronic Coccydynia: A Randomized, Clinical Trial.

作者信息

Ahadi Tannaz, Asilian Mahdiye, Raissi Gholam Reza, Khalifeh Soltani Shayesteh, Soleymanzadeh Hosnieh, Sajadi Simin

机构信息

Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Department of Geriatric, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Arch Bone Jt Surg. 2022 Oct;10(10):877-884. doi: 10.22038/ABJS.2022.58507.2895.

Abstract

BACKGROUND

Corticosteroid injection is frequently used for chronic coccydynia management. Ultrasonography can be used to improve the accuracy of the injection. This study aims to assess the clinical outcome of ultrasound-guided compared to blind coccygeal injection in chronic coccydynia.

METHODS

Thirty patients with chronic coccydynia were randomized into two groups and received a coccygeal corticosteroid injection at maximum tenderness point: 15 patients with and 15 patients without ultrasound guidance. The patient's pain was evaluated with the visual analog scale (VAS) at 1-, 4-, 8-, and 24-week postinjection. Furthermore, the Dallas Pain Questionnaire was assessed before injection; also, four and eight weeks after treatment. The quality of life of patients was evaluated before an assessment and four weeks after the intervention by the SF-36 questionnaire.

RESULTS

The VAS score decreased significantly 24-week after the intervention in both ultrasound-guided and blinded groups ( without any significant difference between the groups (). Similarly, the Dallas pain scale had a significant decrease at eight weeks after intervention in both groups () with no significant difference between the groups (). Although there was a significant improvement in the patient's quality of life in each group eight weeks after the intervention, it was not significantly different between the two groups. Neither of the treatment groups had any adverse effects associated with the injection.

CONCLUSION

There were no significant differences in the clinical outcome of coccygeal ultrasound-guided vs. blind steroid injection for chronic coccydynia.

摘要

背景

皮质类固醇注射常用于慢性尾骨痛的治疗。超声检查可用于提高注射的准确性。本研究旨在评估超声引导下与盲目尾骨注射治疗慢性尾骨痛的临床效果。

方法

30例慢性尾骨痛患者被随机分为两组,在最痛点接受尾骨皮质类固醇注射:15例接受超声引导,15例不接受超声引导。在注射后1周、4周、8周和24周,用视觉模拟量表(VAS)评估患者疼痛程度。此外,在注射前、治疗后4周和8周评估达拉斯疼痛问卷。在评估前和干预后4周,通过SF-36问卷评估患者的生活质量。

结果

干预24周后,超声引导组和盲目注射组的VAS评分均显著降低(两组间无显著差异)。同样,两组干预8周后达拉斯疼痛量表评分均显著降低(两组间无显著差异)。虽然每组干预8周后患者生活质量均有显著改善,但两组间无显著差异。两个治疗组均未出现与注射相关的不良反应。

结论

对于慢性尾骨痛,超声引导下与盲目注射皮质类固醇的临床效果无显著差异。

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