Stewart H D, Quinnell R C, Dann N
Department of Orthopaedic Surgery, Derbyshire Royal Infirmary, Derby, UK.
Br J Rheumatol. 1987 Dec;26(6):424-9. doi: 10.1093/rheumatology/26.6.424.
Fifty consecutive patients starting treatment for sciatica with epidural injections of steroid and local anaesthetic underwent concomitant epidurography. The prognostic potential of this combination was investigated. Epidurography was confirmed as a safe out-patient procedure. Incorrect needle siting accounted for five total and two partial failures. The procedure was found to be a sensitive investigation, 36 showing definite abnormalities. It was of particular value in the diagnosis of lateral canal stenosis. However, it was found to have no prognostic value. For 12 of 16 patients requiring invasive therapy, it was considered that epidurography would have obviated later radiculography had the results been known. It is suggested that the combination of this out-patient investigation with the last of three epidural anaesthetic injections in patients whose symptoms persist, represents an improvement in management both financially and in terms of patient convenience.
连续50例开始接受硬膜外注射类固醇和局部麻醉剂治疗坐骨神经痛的患者同时接受了硬膜外造影。研究了这种联合治疗的预后潜力。硬膜外造影被确认为一种安全的门诊检查方法。穿刺针位置不当导致5例完全失败和2例部分失败。该检查被发现是一种敏感的检查方法，36例显示明确异常。它在侧隐窝狭窄的诊断中具有特殊价值。然而，发现它没有预后价值。对于16例需要侵入性治疗的患者中的12例，如果结果已知，认为硬膜外造影本可避免随后的神经根造影。建议将这种门诊检查与对症状持续的患者进行的三次硬膜外麻醉注射中的最后一次相结合，在经济和患者便利方面都代表了管理上的改进。
