Mayo Clinic Alix School of Medicine, Scottsdale, AZ 85259, United States.
Department of Radiology, Mayo Clinic, Rochester, MN 55902, United States.
Pain Med. 2023 Jul 5;24(7):782-786. doi: 10.1093/pm/pnad029.
To describe the technique, safety profile, and outcome of computed tomography (CT)-guided atlanto-axial lateral articulation injections performed at our institution.
Consecutive cases of all CT-guided atlanto-axial injections performed from January 2017 to April 2022 at our institution were searched in the electronic medical records. Patient charts were reviewed for demographics, characterization of pain, potential altered anatomy, pain level before and immediately after the procedure, procedure technique, complications, and follow-up outcomes, if available.
Forty-five injections in 40 different patients were included. The average age was 67.4 years, and 28 (70%) of the patients were female. Of the 45 injections, 43 (96%) were technically successful. The average change in pain score (0-10) from immediately before to immediately after the injection was -3.36 (SD = 2.87, range = -8 to +3). Of all injections, 14 (31%) had a postprocedural pain score of zero. In 2 cases (4%), patients reported an increase in pain score immediately after the injection. In 3 cases (7%), transient non-vertebral artery vascular uptake of contrast was documented during the procedure, which could be cleared with needle repositioning. There were no complications.
CT-guided atlanto-axial lateral articulation injection is a safe procedure with a high technical success rate. It allows for direct visualization of vital structures and provides an alternative option to the traditional fluoroscopic guidance, especially in cases of prior technically unsuccessful fluoroscopically guided injection or altered anatomy.
描述我们机构进行的 CT 引导寰枢外侧关节注射的技术、安全性和结果。
在电子病历中搜索了我们机构 2017 年 1 月至 2022 年 4 月期间连续进行的所有 CT 引导寰枢关节注射的病例。查阅患者图表以了解人口统计学资料、疼痛特征、潜在的解剖结构改变、治疗前后的疼痛水平、治疗技术、并发症以及随访结果（如果有）。
共纳入 40 名患者的 45 次注射。平均年龄为 67.4 岁，28 名（70%）患者为女性。45 次注射中，43 次（96%）技术上是成功的。注射前后疼痛评分（0-10）的平均变化为-3.36（SD=2.87，范围=-8 至+3）。所有注射中有 14 次（31%）在治疗后疼痛评分达到 0 分。2 例（4%）患者在注射后立即报告疼痛评分增加。3 例（7%）在手术过程中记录到短暂的非椎动脉血管对比剂摄取，可通过重新定位针头来清除。没有并发症。
CT 引导寰枢外侧关节注射是一种安全的操作，具有很高的技术成功率。它可以直接观察到重要结构，并为传统的透视引导提供了替代选择，尤其是在先前透视引导注射技术不成功或解剖结构改变的情况下。
