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CT引导下颈椎小关节腔内注射类固醇治疗神经根型颈椎病的疗效

Efficacity of CT-guided intra-articular cervical facet steroid injection for cervical radiculopathy.

作者信息

Ravenel Clément, Martin-Peltier Charlotte, Lacroix Maxime, Mihoubi-Bouvier Fadila, Nguyen Christelle, Touzé Romain, Drapé Jean-Luc

机构信息

Service radiologie B, hôpital Cochin, AP-HP, Centre-Université Paris Cité, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.

UFR de médecine, faculté de santé, Université Paris Cité, 75006 Paris, France.

出版信息

Res Diagn Interv Imaging. 2024 Jun 11;11:100050. doi: 10.1016/j.redii.2024.100050. eCollection 2024 Sep.

Abstract

BACKGROUND

Traditionally, transforaminal steroid injection is performed in the management of cervical radiculopathy in medical failure treatment but carried a true risk of catastrophic complication. Another approach currently used is to perform intra-articular facet steroid injection to reach the epidural space.

PURPOSE

The aim of this study was to describe the evolution of symptoms following intra-articular facet steroid injection in cervical radiculopathy.

MATERIAL AND METHODS

We conducted a retrospective study. We assessed all patients who had a CT-guided intra-articular facet steroid injection in our center (xx, xx, xx) from December 2015 to February 2021. Cervical MR pretherapeutic images were analyzed and classified according to cervical pain etiology: uncodiscarthrosis, disk herniation or congestive cervical posterior osteo-arthritis. All patients had clinical initial evaluation and then follow-up at 1 and 6 months. Pain severity was rated on a visual analog scale and expressed as a percentage of improvement.

RESULTS

Ninety-three patients were included. There were 56 patients with uncodiscarthrosis, 29 with a disk herniation and 8 with a cervical posterior congestive osteoarthritis. A significant improvement of the visual analog scale percentage was found for all patient at 1 and 6 months ( < 0.01). Visual analog scale percentage improvement was about 50 % for all etiologies. For all patients, no severe complications were reported.

CONCLUSION

Intra-articular facet steroid injection may be considered for the treatment of cervical radiculopathy when other medical treatments have failed.

摘要

背景

传统上,经椎间孔类固醇注射用于治疗药物治疗无效的颈神经根病,但存在发生灾难性并发症的真正风险。目前使用的另一种方法是进行关节内小关节类固醇注射以到达硬膜外间隙。

目的

本研究的目的是描述关节内小关节类固醇注射治疗颈神经根病后症状的演变。

材料与方法

我们进行了一项回顾性研究。我们评估了2015年12月至2021年2月在我们中心(xx,xx,xx)接受CT引导下关节内小关节类固醇注射的所有患者。对治疗前的颈椎磁共振成像进行分析,并根据颈部疼痛病因进行分类:钩椎关节病、椎间盘突出或颈椎后纵韧带骨化症。所有患者均进行了临床初始评估,然后在1个月和6个月时进行随访。疼痛严重程度采用视觉模拟评分法进行评估,并以改善百分比表示。

结果

纳入93例患者。其中钩椎关节病56例,椎间盘突出29例,颈椎后纵韧带骨化症8例。所有患者在1个月和6个月时视觉模拟评分百分比均有显著改善(<0.01)。所有病因的视觉模拟评分百分比改善约为50%。所有患者均未报告严重并发症。

结论

当其他药物治疗无效时,关节内小关节类固醇注射可考虑用于治疗颈神经根病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a2b/11265198/3e0d71775202/gr1.jpg

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