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骶管阻滞治疗伴有神经根冗余综合征的椎管狭窄症的疗效。

Effectiveness of caudal block in patients with spinal stenosis accompanied by redundant nerve root syndrome.

机构信息

Department of Anesthesiology and Pain Medicine, Konyang University Hospital, Daejeon, Republic of Korea.

Department of Radiology, Konyang University Hospital, Daejeon, Republic of Korea.

出版信息

J Int Med Res. 2023 Feb;51(2):3000605231153326. doi: 10.1177/03000605231153326.

Abstract

OBJECTIVE

Redundant nerve root syndrome (RNRS) is characterized by tortuous, elongated, and enlarged nerve roots in patients with lumbar spinal stenosis. This study was performed to evaluate the effects of caudal block in patients with RNRS and assess factors associated with RNRS.

METHODS

Patients with lumbar spinal stenosis who underwent caudal block were retrospectively analyzed. A comparative analysis of pain reduction was conducted between patients with RNRS (Group R) and those without RNRS (Group C). Generalized estimating equation analysis was used to identify factors related to the treatment response. RNRS-associated factors were analyzed using logistic regression analysis.

RESULTS

In total, 54 patients were enrolled (Group R, n = 22; Group C, n = 32). Group R had older patients than Group C. The caudal block showed less pain reduction in Group R than in Group C, but the difference was not statistically significant. Generalized estimating equation analysis showed that RNRS was the factor significantly associated with the treatment response. The dural sac anteroposterior diameter and left ligamentum flavum thickness were associated with RNRS in the logistic regression analysis.

CONCLUSIONS

Caudal block tended to be less effective in patients with than without RNRS, but the difference was not statistically significant.

摘要

目的

神经根冗余综合征(RNRS)的特征是腰椎管狭窄症患者的神经根迂曲、延长和增粗。本研究旨在评估骶管阻滞对 RNRS 患者的疗效,并评估与 RNRS 相关的因素。

方法

回顾性分析接受骶管阻滞的腰椎管狭窄症患者。对具有 RNRS(R 组)和不具有 RNRS(C 组)的患者的疼痛缓解进行了比较分析。采用广义估计方程分析确定与治疗反应相关的因素。采用逻辑回归分析对 RNRS 相关因素进行分析。

结果

共纳入 54 例患者(R 组,n=22;C 组,n=32)。R 组患者年龄大于 C 组。与 C 组相比,R 组的骶管阻滞显示出的疼痛缓解程度较低,但差异无统计学意义。广义估计方程分析显示,RNRS 是与治疗反应显著相关的因素。在逻辑回归分析中,硬膜囊前后径和左黄韧带厚度与 RNRS 相关。

结论

骶管阻滞在具有 RNRS 的患者中的效果似乎不如在不具有 RNRS 的患者中,但差异无统计学意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a860/9909078/514b8ee44f57/10.1177_03000605231153326-fig1.jpg

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