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超声引导下颈椎选择性神经根阻滞与透视引导下椎板间硬膜外注射治疗神经根型颈椎病的随机、前瞻性对照研究

Ultrasound-Guided Cervical Selective Nerve Root Block versus Fluoroscopy-Guided Interlaminar Epidural Injection for Cervical Radicular Pain: A Randomized, Prospective, Controlled Study.

作者信息

Kose Halil Cihan, Guven Kose Selin, Celikel Feyza, Tulgar Serkan, Akkaya Omer Taylan

机构信息

Department of Pain Medicine, Health Science University Kocaeli City Hospital, 41060 Kocaeli, Turkey.

Department of Physical Therapy and Rehabilitation, Sakarya Training and Research Hospital, 54120 Sakarya, Turkey.

出版信息

J Pers Med. 2024 Jul 4;14(7):721. doi: 10.3390/jpm14070721.

Abstract

Ultrasound (US)-guided cervical selective nerve root block (CSNRB) procedures are increasingly being performed as an alternative to conventional fluoroscopy (FL)-guided epidural injections for the treatment of cervical radicular pain. The aim of this study was to compare the effectiveness of US-guided CSNRB versus FL-guided interlaminar cervical epidural steroid injection (IL-CESI) for cervical radicular pain. A total of 60 patients with cervical radicular pain due to a single-level disc herniation were randomized into either the FL or US group. The numeric rating scale, Short Form-36, and neck disability index were evaluated before treatment at months 1, 3, and 6 after treatment. Procedure time, complications, pain medication consumption, and patient satisfaction were also recorded. Patients experienced significant improvement in pain, disability, and quality of life scores up to 6 months after the procedure ( < 0.001). Treatment success rate was achieved in 56.6% of the IL-CESI group and 50% of the CSNRB group without any significant difference between the study arms ( = 0.617). US-guided CSNRB was shown to be as effective as the FL-guided IL-CESI in the treatment of cervical radicular pain, in addition to the absence of radiation exposure and requiring less procedure time.

摘要

超声(US)引导下的颈椎选择性神经根阻滞(CSNRB)作为传统透视(FL)引导下硬膜外注射治疗颈椎神经根性疼痛的替代方法,应用越来越广泛。本研究旨在比较US引导下CSNRB与FL引导下颈椎间孔硬膜外类固醇注射(IL-CESI)治疗颈椎神经根性疼痛的有效性。将60例因单节段椎间盘突出导致颈椎神经根性疼痛的患者随机分为FL组或US组。在治疗前、治疗后1个月、3个月和6个月时评估数字评分量表、简明健康状况调查量表(Short Form-36)和颈部功能障碍指数。记录操作时间、并发症、止痛药物消耗和患者满意度。患者在术后6个月内疼痛、功能障碍和生活质量评分均有显著改善(<0.001)。IL-CESI组的治疗成功率为56.6%,CSNRB组为50%,两组之间无显著差异(=0.617)。结果表明,US引导下的CSNRB在治疗颈椎神经根性疼痛方面与FL引导下的IL-CESI同样有效,此外还不存在辐射暴露且操作时间更短。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb75/11278421/93f5048f241a/jpm-14-00721-g001.jpg

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