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超声引导注射治疗颈椎小关节综合征的疗效与准确性:一项系统评价

Efficacy and Accuracy of Ultrasound Guided Injections in the Treatment of Cervical Facet Joint Syndrome: A Systematic Review.

作者信息

Viva Mattia Giuseppe, Sveva Valerio, Ruggiero Marco, Fai Annatonia, Savina Alessio, Perrone Riccardo, Donati Danilo, Tedeschi Roberto, Monticone Marco, Farì Giacomo, Bernetti Andrea

机构信息

Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00189 Rome, Italy.

Physical and Rehabilitation Medicine 2, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy.

出版信息

J Clin Med. 2024 Sep 6;13(17):5290. doi: 10.3390/jcm13175290.

Abstract

: Cervical facet joint syndrome (CFJS) is a frequent cause of neck pain and motor disability. Among the available therapies for CFJS, ultrasound (US)-guided injections are becoming more and more widespread, but the evidence about their accuracy and effectiveness is still debated in the scientific literature. The aim of this systematic review is to assess efficacy, accuracy and feasibility of US-guided cervical facet injections for the related chronic neck pain treatment. : This review was conducted following the preferred reporting items for systematic reviews and meta-analysis 2020 (PRISMA) statement guidelines. The scientific articles were identified through the PubMed, Google Scholar and Cochrane Library databases. Qualitative assessment of the selected studies was carried out using the modified Oxford quality scoring system. Nine studies with a total of 958 patients were included in this review. The risk of bias was assessed using the Cochrane Collaboration tool. The protocol was registered at PROSPERO 2024 (n°CRD42024512214). The results of this review suggest that the US-guided cervical facet injection for CFJS treatment is an effective technique in terms of accuracy (using the lateral technique it ranges from 92% to 98%), and efficiency (it grants pain relief with a decrease in the procedure time and fewer needle passes in comparison with the X-ray-guided technique, which also involves radiation exposure). US-guided injections are a safe and effective method to treat this musculoskeletal disease, granting a high functional recovery and long-lasting pain relief, net of the used drugs. However, these procedures are strictly operator-dependent and require important training to acquire good expertise.

摘要

颈椎小关节综合征(CFJS)是颈部疼痛和运动功能障碍的常见原因。在CFJS的现有治疗方法中,超声(US)引导下的注射越来越普遍,但关于其准确性和有效性的证据在科学文献中仍存在争议。本系统评价的目的是评估US引导下颈椎小关节注射治疗相关慢性颈部疼痛的疗效、准确性和可行性。

本评价遵循2020年系统评价和Meta分析优先报告项目(PRISMA)声明指南进行。通过PubMed、谷歌学术和Cochrane图书馆数据库检索科学文章。使用改良的牛津质量评分系统对所选研究进行定性评估。本评价纳入了9项研究,共958例患者。使用Cochrane协作工具评估偏倚风险。该方案已在PROSPERO 2024(编号CRD42024512214)注册。本评价结果表明,US引导下的颈椎小关节注射治疗CFJS在准确性(采用外侧技术,准确率在92%至98%之间)和效率方面是一种有效的技术(与X射线引导技术相比,它能减轻疼痛,减少操作时间和穿刺次数,而X射线引导技术还涉及辐射暴露)。US引导下的注射是治疗这种肌肉骨骼疾病的一种安全有效的方法,无论使用何种药物,都能实现高功能恢复和持久的疼痛缓解。然而,这些操作严格依赖于操作者,需要重要的培训才能获得良好的专业技能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94f2/11396720/bc7d3e7431cc/jcm-13-05290-g001.jpg

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