Department of Orthopaedics, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan.
Department of Rehabilitation Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan.
Sci Rep. 2023 Aug 24;13(1):13817. doi: 10.1038/s41598-023-40376-2.
Because fascial entrapment neuropathy can occur in multiple locations, ultrasound-guided nerve hydrodissection has become a key component of the treatment of cervical radicular pain. In this paper, we propose a combination of injectates used for nerve hydrodissection of the cervical nerve roots and compare the clinical outcomes of this treatment among patients with different severities of stenosis. This is a retrospective cohort study designed to compare outcomes between patients with mild stenosis and moderate to severe stenosis. Forty-four patients with mild cervical stenosis and 30 patients with moderate to severe cervical stenosis were consecutively enrolled into two groups. A 10-mL mixture in a single level consisting of 5% in Dextrose, 0.2% lidocaine (Xylocaine), and 4 mg betamethasone (Rinderon) was used for nerve roots hydrodissection. The two groups were compared with regard to their numeric rating scales (NRS) of pain, proportion of patients who exhibited a favorable outcome (a reduction of pain ≥ 50%), duration of patient exhibited a favorable outcome, and occurrence of serious complications and minor side effects. The follow-up period ranged from 3 to 20 months. The NRS of both groups improved significantly by 1 week, 1 month, 3 months, and final follow-up after the initial injection. Differences in the groups' NRS, proportion of patients who exhibited a favorable outcome, duration of patient exhibited a favorable outcome, and occurrence of serious complications and minor side effects were nonsignificant. There were 4 patients (5.4%) experienced dizziness in that resolved without further treatment. Ultrasound-guided nerve hydrodissection of cervical nerve roots is a safe procedure that reduces pain associated with cervical radicular pain, even in patients with moderate to severe stenosis.
由于筋膜卡压性神经病可能发生在多个部位，超声引导下神经松解术已成为治疗颈椎神经根痛的关键组成部分。在本文中，我们提出了一种联合应用于颈椎神经根神经松解术的注射剂，并比较了不同严重程度狭窄患者的治疗效果。这是一项回顾性队列研究，旨在比较轻度狭窄和中重度狭窄患者的结果。连续纳入 44 例轻度颈椎狭窄和 30 例中重度颈椎狭窄患者，分为两组。在单个节段中使用 10mL 的混合物，其中包含 5%葡萄糖、0.2%利多卡因（Xylocaine）和 4mg 倍他米松（Rinderon），用于神经根松解。比较两组患者的数字评分量表（NRS）疼痛评分、表现出良好结果（疼痛减轻≥50%）的患者比例、表现出良好结果的患者持续时间，以及严重并发症和轻微副作用的发生情况。随访时间为 3 至 20 个月。两组患者的 NRS 在初次注射后 1 周、1 个月、3 个月和最终随访时均显著改善。两组患者的 NRS、表现出良好结果的患者比例、表现出良好结果的患者持续时间、严重并发症和轻微副作用的发生情况差异无统计学意义。有 4 例（5.4%）患者出现头晕，无需进一步治疗即可缓解。超声引导下颈椎神经根神经松解术是一种安全的手术，可减轻与颈椎神经根痛相关的疼痛，即使在中重度狭窄的患者中也是如此。
