Brandt William J, Han Tatiana J, Varrassi Giustino, Shekoohi Sahar, Kaye Alan D
School of Medicine, Louisiana State University Health Sciences Center, Shreveport, USA.
Internal Medicine, Feist-Weiller Cancer Center, Shreveport, USA.
Cureus. 2024 Sep 24;16(9):e70102. doi: 10.7759/cureus.70102. eCollection 2024 Sep.
Congenital bleeding disorders involve specific deficiencies in factors that can alter hemostasis, increasing the risk of bleeding. This case report describes a patient with Von Willebrand's disease who was diagnosed with severe thoracic facet arthritis with pain scores of 9/10. An antihemophilic factor (vWF, Humate-P) injection was administered by a hematologist just before thoracic medial branch blocks. Rather than receiving traditional second thoracic medial branch blocks on another day, the patient, after documenting complete relief of his symptoms with 1% lidocaine, received bilateral T6-8 thoracic radiofrequency ablations, which resulted in complete resolution of his symptoms. A second dose of Humate-P was delivered 24 hours post-procedure. Careful planning with hematologists can enable safe and effective interventional pain procedures in patients with congenital hematologic disorders. This appears to be the first case report in world literature of a patient with Von Willebrand's disease successfully receiving thoracic radiofrequency ablations.
先天性出血性疾病涉及可改变止血功能的特定因子缺乏，从而增加出血风险。本病例报告描述了一名患有血管性血友病的患者，该患者被诊断为严重的胸椎小关节关节炎，疼痛评分为9/10。在进行胸椎内侧支阻滞之前，血液科医生给予了抗血友病因子（血管性血友病因子，Humate-P）注射。该患者在使用1%利多卡因记录症状完全缓解后，未在另一天接受传统的第二胸椎内侧支阻滞，而是接受了双侧T6-8胸椎射频消融术，症状完全缓解。术后24小时给予第二剂Humate-P。与血液科医生仔细规划可以使先天性血液系统疾病患者安全有效地进行介入性疼痛治疗。这似乎是世界文献中首例成功接受胸椎射频消融术的血管性血友病患者的病例报告。
