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经椎间孔神经阻滞与盘内阻滞诊断椎间盘源性腰痛效果的比较:一项回顾性队列研究。

Comparison of the effect of diagnosing discogenic low back pain by sinuvertebral nerve block versus discoblock a retrospective cohort study.

机构信息

Guangzhou Development District Hospital, Guangzhou, 510730, China.

Department of Orthopedics, The Third Affiliated Hospital of Southern Medical University, No. 183, Zhongshan Rd West, Guangzhou, 510630, China.

出版信息

Eur Spine J. 2023 Jun;32(6):2093-2100. doi: 10.1007/s00586-023-07732-2. Epub 2023 May 3.

Abstract

PURPOSE

The purpose of this study was to evaluate the efficacy of sinuvertebral nerve blocks in the diagnosis of discogenic low back pain.

PATIENTS AND METHODS

In this retrospective cohort study, the data of 48 patients with high clinical suspicion of discogenic low back pain from L4/5 who received nerve block treatment from 2017 to 2018 were collected. Twenty-four patients received discoblock (L4/5 intradiscal injection of 1 ml 0.5% lidocaine) and another 24 patients received the sinuvertebral nerve block(L4/5 intervertebral space injection of 0.5 ml 0.5% lidocaine bilaterally). Percutaneous endoscopic radiofrequency thermal annuloplasty was performed in patients who responded to the diagnostic block. The visual analogue scale scores and Oswestry Disability Index scores in both groups before and 1, 3, and 12 months after surgery were compared.

RESULTS

Ten patients with a negative diagnostic block did not undergo surgery. Eighteen patients in the discoblock group and 20 patients in the sinuvertebral nerve block group showed a positive response and were evaluated. There were no differences in visual analogue scale or Oswestry Disability Index scores between the two cohorts at baseline or at all time points postsurgery (all p > 0.05). When comparing baseline values to all time points postsurgery improved visual analogue scale scores, and Oswestry Disability Index scores were observed within both cohorts (all p < 0.05).

CONCLUSION

The effect of sinuvertebral nerve block as a diagnostic tool for discogenic low back pain is similar to that of discoblock, and it is a promising tool that deserves further study.

摘要

目的

本研究旨在评估脊神经根阻滞在椎间盘源性腰痛诊断中的疗效。

患者和方法

在这项回顾性队列研究中,收集了 2017 年至 2018 年接受神经阻滞治疗的 48 例高度怀疑椎间盘源性腰痛的 L4/5 患者的数据。24 例患者接受椎间盘阻滞(L4/5 椎间盘内注射 1ml0.5%利多卡因),另 24 例患者接受脊神经根阻滞(L4/5 椎间孔双侧注射 0.5ml0.5%利多卡因)。对诊断性阻滞有反应的患者进行经皮内镜射频热环缩术。比较两组患者手术前后 1、3 和 12 个月的视觉模拟评分(VAS)和 Oswestry 功能障碍指数(ODI)评分。

结果

10 例诊断性阻滞阴性的患者未行手术。椎间盘阻滞组 18 例和脊神经根阻滞组 20 例患者出现阳性反应并进行了评估。两组患者基线时及术后各时间点 VAS 和 ODI 评分均无差异(均 P>0.05)。两组患者基线时 VAS 和 ODI 评分均高于术后各时间点(均 P<0.05)。

结论

脊神经根阻滞作为椎间盘源性腰痛的诊断工具的效果与椎间盘阻滞相似,是一种有前途的工具,值得进一步研究。

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