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肩终末感觉关节神经射频消融术治疗因肩袖病变和骨关节炎引起的非手术难治性肩痛:技术说明。

Shoulder terminal sensory articular nerve radiofrequency ablation for nonsurgical refractory shoulder pain due to rotator cuff pathology and osteoarthritis: a technical note.

机构信息

Department of Physical Medicine and Rehabilitation, University of Utah School of Medicine, Salt Lake City, UT, United States.

Tennessee Orthopaedic Alliance, Nashville, TN, United States.

出版信息

Pain Med. 2024 Sep 1;25(9):563-567. doi: 10.1093/pm/pnae035.

Abstract

BACKGROUND

Given the high prevalence of chronic shoulder pain and encouraging early results of terminal sensory articular branch radiofrequency ablation to treat shoulder pain, research is warranted to refine the procedural technique on the basis of updated neuroanatomic knowledge with the goal of further improving patient outcomes.

OBJECTIVE

We describe an updated radiofrequency ablation protocol that accounts for varied locations of the terminal sensory articular branches of the suprascapular, axillary, subscapular, and lateral pectoral nerves within individual patients.

DESIGN

Technical note.

METHODS

Cadaveric studies delineating the sensory innervation of the shoulder joint were reviewed, and a more comprehensive radiofrequency ablation protocol is proposed relative to historical descriptions.

CONCLUSIONS

The proposed radiofrequency ablation protocol, which is based on neuroanatomic dissections of the shoulder joint, will provide a safe means of more complete sensory denervation and potentially improve clinical outcomes compared with historical descriptions, the efficacy of the new protocol must be confirmed in prospective studies.

摘要

背景

鉴于慢性肩部疼痛的高患病率,以及终端感觉关节支射频消融术治疗肩部疼痛的令人鼓舞的早期结果,有必要基于更新的神经解剖学知识来完善手术技术,以进一步提高患者的治疗效果。

目的

我们描述了一种更新的射频消融方案,该方案考虑了个体患者中肩胛上神经、腋神经、肩胛下神经和胸外侧神经的终端感觉关节支的不同位置。

设计

技术说明。

方法

对肩部关节感觉神经支配的尸体研究进行了回顾,并提出了一种相对于既往描述更为全面的射频消融方案。

结论

该方案基于对肩关节的神经解剖学研究,与既往描述相比,将为更完全的感觉神经切断提供一种安全手段,并可能改善临床效果。然而,新方案的疗效必须通过前瞻性研究加以证实。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52ca/11369352/1d6c3596bc32/pnae035f1.jpg

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