影像引导下退行性腰椎疾病的微创治疗选择:当前可能性的实用概述
Image-Guided Minimally Invasive Treatment Options for Degenerative Lumbar Spine Disease: A Practical Overview of Current Possibilities.
作者信息
Taninokuchi Tomassoni Makoto, Braccischi Lorenzo, Russo Mattia, Adduci Francesco, Calautti Davide, Girolami Marco, Vita Fabio, Ruffilli Alberto, Manzetti Marco, Ponti Federico, Matcuk George R, Mosconi Cristina, Cirillo Luigi, Miceli Marco, Spinnato Paolo
机构信息
Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy.
Radiology Department, IRCCS Azienda Ospedaliero-Universitaria Sant'Orsola Malpighi, 40138 Bologna, Italy.
出版信息
Diagnostics (Basel). 2024 May 30;14(11):1147. doi: 10.3390/diagnostics14111147.
Lumbar back pain is one of the main causes of disability around the world. Most patients will complain of back pain at least once in their lifetime. The degenerative spine is considered the main cause and is extremely common in the elderly population. Consequently, treatment-related costs are a major burden to the healthcare system in developed and undeveloped countries. After the failure of conservative treatments or to avoid daily chronic drug intake, invasive treatments should be suggested. In a world where many patients reject surgery and prefer minimally invasive procedures, interventional radiology is pivotal in pain management and could represent a bridge between medical therapy and surgical treatment. We herein report the different image-guided procedures that can be used to manage degenerative spine-related low back pain. Particularly, we will focus on indications, different techniques, and treatment outcomes reported in the literature. This literature review focuses on the different minimally invasive percutaneous treatments currently available, underlining the central role of radiologists having the capability to use high-end imaging technology for diagnosis and subsequent treatment, allowing a global approach, reducing unnecessary surgeries and prolonged pain-reliever drug intake with their consequent related complications, improving patients' quality of life, and reducing the economic burden.
腰背痛是全球致残的主要原因之一。大多数患者一生中至少会抱怨一次背痛。脊柱退变被认为是主要原因,在老年人群中极为常见。因此,治疗相关费用对发达国家和不发达国家的医疗系统都是一项重大负担。在保守治疗失败后或为避免每日长期服用药物时,应建议采用侵入性治疗。在一个许多患者拒绝手术而更喜欢微创手术的世界里,介入放射学在疼痛管理中起着关键作用,并且可以成为药物治疗和手术治疗之间的桥梁。我们在此报告可用于治疗与脊柱退变相关的下腰痛的不同影像引导程序。特别是,我们将重点关注文献中报道的适应症、不同技术和治疗结果。这篇文献综述聚焦于目前可用的不同微创经皮治疗方法,强调了放射科医生的核心作用,他们有能力使用高端成像技术进行诊断和后续治疗,从而实现整体治疗方法,减少不必要的手术和长期服用止痛药物及其相关并发症,提高患者生活质量,并减轻经济负担。