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腰椎内镜下小关节去神经术:一项回顾性分析

Endoscopic Facet Joint Denervation on the Lumbar Spine: A Retrospective Analysis.

作者信息

Wallscheid Franziska, Manthey Maximilian, Olsen Jerome, Oikonomidis Stavros, Meyer Carolin, Eysel Peer, Löhrer Lars, Bredow Jan

机构信息

Department of Orthopaedic and Trauma Surgery, Krankenhaus Porz am Rhein gGmbH, Cologne, Germany.

Department of Orthopaedic and Trauma Surgery, DIAKOVERE Friederikenstift, Hannover, Germany.

出版信息

Asian Spine J. 2023 Apr;17(2):382-391. doi: 10.31616/asj.2021.0150. Epub 2022 Dec 5.

Abstract

STUDY DESIGN

This single-center retrospective study analyzed patients with chronic low back pain (CLBP) who underwent endoscopic facet joint denervation (EFJD) between April 2018 and May 2019.

PURPOSE

This study was designed to investigate the effectiveness of EFJD in treating CLBP.

OVERVIEW OF LITERATURE

CLBP is a challenging burden to healthcare systems worldwide. As up to 45% of cases originate from the lumbar facet joints, sufficient therapy strategies must be developed. EFJD offers a precise depiction of the dorsal medial ramus and the facet joint capsule.

METHODS

In this study, 64 patients who underwent EFJD were included. The main outcome of interest was patients' Visual Analog Scale (VAS) pain score, which was recorded at 3-time points (i.e., before operation and 6 weeks and 12 months after surgery).

RESULTS

EFJD effectively reduced the VAS pain scores by 58% in the short term (6 weeks) and 38% in the long term (12 months). Patients with isolated facet joint osteoarthritis benefited more (p <0.001).

CONCLUSIONS

EFJD is a good treatment alternative for CLBP originating from the facet joints, particularly in patients with isolated facet joint osteoarthritis. Moreover, this method can address not only the dorsal medial ramus but also the surrounding tissue (e.g., facet joint capsule, facet joint effusion, and osteophytes) as the origin of CLBP.

摘要

研究设计

本单中心回顾性研究分析了2018年4月至2019年5月期间接受内镜下小关节去神经支配术(EFJD)的慢性下腰痛(CLBP)患者。

目的

本研究旨在探讨EFJD治疗CLBP的有效性。

文献综述

CLBP是全球医疗系统面临的一项具有挑战性的负担。由于高达45%的病例起源于腰椎小关节,必须制定充分的治疗策略。EFJD能精确显示背内侧支和小关节囊。

方法

本研究纳入了64例行EFJD的患者。主要观察指标是患者的视觉模拟量表(VAS)疼痛评分,在3个时间点(即术前、术后6周和12个月)记录。

结果

EFJD在短期内(6周)有效降低VAS疼痛评分58%,长期内(12个月)降低38%。单纯小关节骨关节炎患者获益更多(p<0.001)。

结论

EFJD是治疗源于小关节的CLBP的一种良好治疗选择,尤其是对于单纯小关节骨关节炎患者。此外,该方法不仅可以处理背内侧支,还可以处理作为CLBP起源的周围组织(如小关节囊、小关节积液和骨赘)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/687e/10151623/57522d8b0aff/asj-2021-0150f1.jpg

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