Kubihal Vijay, Mukund Amar, Pandey Yasha, Vashistha Chitranshu, Maiwall Rakhi, Patidar Yashwant, Yadav Anil Yogendra, Koul Roshan Lal, Sarin Shiv Kumar
Department of Interventional Radiology, Institute of Liver and Biliary Sciences, New Delhi 110070, India.
Indira IVF Fertility Center, New Delhi 110008, India.
Diagnostics (Basel). 2023 Jan 25;13(3):438. doi: 10.3390/diagnostics13030438.
To study the prevalence of back pain in patients of Budd-Chiari syndrome (BCS) with inferior vena cava (IVC) obstruction, and to evaluate the role of IVC recanalization in resolution of back pain.
All patients with BCS and IVC obstruction who underwent IVC recanalization between January 2018 and October 2022 were included. Patients with degenerative spine disease or other identifiable causes for back pain were excluded; remaining patients were assessed for the presence of back pain. In patients with back pain, pain relief was assessed at 24 h following IVC recanalization.
Fifty-eight patients with BCS and IVC occlusion were identified, of which six with degenerative spine diseases were excluded. Of the remaining 52 patients, 34 (65.4%) had back pain, with pain score between 3 and 9. Engorged epidural venous plexus on preprocedural imaging ( = 0.002), and degree of luminal narrowing ( = 0.021) had a significant association with back pain. Twenty-nine of thirty-four patients (85.3%) with back pain had pain relief immediately following IVC recanalization, more so in patients with engorged epidural venous plexus on preprocedural imaging ( < 0.001).
Back pain is one of the under-reported symptoms of IVC obstruction in BCS. IVC recanalization by IVC angioplasty with or without stenting relieves back pain due to the decompression of engorged epidural veins.
研究布加综合征（BCS）合并下腔静脉（IVC）梗阻患者背痛的患病率，并评估IVC再通在缓解背痛中的作用。
纳入2018年1月至2022年10月期间接受IVC再通的所有BCS合并IVC梗阻患者。排除患有退行性脊柱疾病或其他可识别的背痛原因的患者；其余患者评估是否存在背痛。对于有背痛的患者，在IVC再通后第24小时评估疼痛缓解情况。
共识别出58例BCS合并IVC闭塞患者，其中6例患有退行性脊柱疾病被排除。其余52例患者中，34例（65.4%）有背痛，疼痛评分在3至9分之间。术前影像学检查发现硬膜外静脉丛充血（P = 0.002）和管腔狭窄程度（P = 0.021）与背痛显著相关。34例有背痛的患者中有29例（85.3%）在IVC再通后立即疼痛缓解，术前影像学检查发现硬膜外静脉丛充血的患者疼痛缓解更明显（P < 0.001）。
背痛是BCS中IVC梗阻未被充分报道的症状之一。通过IVC血管成形术（有或无支架置入）进行IVC再通可因充血的硬膜外静脉减压而缓解背痛。
