Yan'an University, Yan'an, 716000, Shannxi, China.
The Spine Surgery Department of Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710054, Shannxi, China.
Sci Rep. 2024 Feb 8;14(1):3235. doi: 10.1038/s41598-024-53809-3.
The purpose of this study is to compare the accuracy and effectiveness of ultrasound-guided and fluoroscopy-guided lumbar selective nerve root block (SNRB), and to explore the feasibility of ultrasound-guided methods. This retrospective study included patients with lumbar radicular pain who underwent ultrasound-guided and fluoroscopy-guided selective nerve root block at Honghui Hospital Affiliated to Xi'an Jiaotong University from August 2020 to August 2022. Patients were divided into U-SNRB group and F-SNRB group according to ultrasound-guided or fluoroscopy-guided selective nerve root block. There were 43 patients in U-SNRB group and 20 patients in F-SNRB group. The pain visual analogue scale (VAS) scores, Japanese Orthopaedic Association (JOA) scores, related indexes and complications were recorded and compared between the two groups before, 30 min, 1 month and 6 months after block. To evaluate the feasibility, accuracy and effectiveness of ultrasound-guided selective nerve root block. There were no complications in the process of selective nerve root block in both groups. The operating time and the times of closing needle angle adjustment in U-SNRB group were better than those in F-SNRB group, and the difference was statistically significant (P < 0.05). The VAS score and JOA score of patients in the two groups were significantly improved 30 min after block, 1 month and 6 months after block, and the difference was statistically significant (P < 0.05). There was no significant difference between the two groups (P > 0.05). The accuracy of ultrasound-guided selective nerve root block and the degree of pain relief of patients were similar to those of fluoroscopy guidance, but the operation time and needle angle adjustment times were significantly less than that of fluoroscopy, and could effectively reduce radiation exposure. Therefore, it can be used as a better way to guide for choice.
本研究旨在比较超声引导与透视引导下腰椎选择性神经根阻滞(SNRB)的准确性和有效性,并探讨超声引导方法的可行性。本回顾性研究纳入了 2020 年 8 月至 2022 年 8 月在西安交通大学附属红会医院行超声或透视引导下选择性神经根阻滞的腰椎根性痛患者。根据不同的引导方式将患者分为 U-SNRB 组和 F-SNRB 组,U-SNRB 组 43 例,F-SNRB 组 20 例。记录并比较两组患者阻滞前、阻滞后 30min、1 个月及 6 个月时的疼痛视觉模拟评分(VAS)、日本骨科协会(JOA)评分及相关指标,比较两组并发症发生情况。评价超声引导下选择性神经根阻滞的可行性、准确性及有效性。两组患者选择性神经根阻滞过程中均无并发症发生。U-SNRB 组的操作时间及调整针尖角度次数均优于 F-SNRB 组,差异有统计学意义(P < 0.05)。两组患者 VAS 评分、JOA 评分于阻滞后 30min、1 个月及 6 个月均较阻滞前显著改善,差异有统计学意义(P < 0.05),但两组间比较差异无统计学意义(P > 0.05)。超声引导下选择性神经根阻滞的准确性及患者的疼痛缓解程度与透视引导相似,但操作时间及针尖角度调整次数明显少于透视引导,能有效减少辐射暴露,可作为一种更好的引导选择方式。