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骶管硬膜外阻滞联合经椎间孔神经根阻滞治疗腰椎退行性疾病的成本效益分析

COMBINED TECHNIQUES OF CAUDAL EPIDURAL BLOCK AND TRANSFORAMINAL NERVE ROOT BLOCK IN THE TREATMENT OF DEGENERATIVE DISEASES OF THE LUMBAR SPINE: A COST-EFFECTIVENESS ANALYSIS.

作者信息

Nogueira Marília de Jesus, Marin Anderson Gomes, Pontes Mariana Demétrio de Sousa, Herrero Carlos Fernando Pereira da Silva

机构信息

Grupo São Lucas, Departamento de Ortopedia e Traumatologia Ribeirao Preto, Sao Paulo, Brazil.

Universidade de São Paulo, Faculdade de Medicina, Departamento de Ortopedia e Traumatologia, Ribeirao Preto, Sao Paulo, Brazil.

出版信息

Acta Ortop Bras. 2024 Oct 28;32(5):e276189. doi: 10.1590/1413-785220243205e276189. eCollection 2024.

Abstract

OBJECTIVE

This study aims to assess cost-effectiveness of caudal epidural block with transforaminal nerve root block in the treatment of degenerative diseases of the lumbar spine.

METHODS

A total of 47 patients with lumbar sciatica symptoms were included. Low back pain and leg pain were assessed using the visual analogue scale (VAS), both in the pre-procedure and one week after. The cost-effectiveness and value required to improve each point on the VAS were estimated using addition, division, and rule of three calculations.

RESULTS

For low back pain, scores ranging from 2 to 10 were found before the procedure, with a mean of 7.5 ± 2.14 (95%CI: 6.8-8.1). A week after, these scores ranged from 0 to 10, with a mean of 3.1±2.8 (95%CI: 2.3-4.0; p < 0.0001). Regarding leg pain, scores ranging from 1 to 10 were noted before the procedure, with a mean of 6.8 ± 2.5 (95%CI: 6.1-7.4). A week after, these scores ranged from 0 to 9, with mean of 2.4 ± 2.5 (95%CI: 1.8-3.1; p < 0.0001). The cost of the materials used during the procedure was 214.72 BRL.

CONCLUSION

Caudal epidural with transforaminal nerve root block were a cost-effective treatment modality for patients with degenerative diseases of the lumbar spine.

摘要

目的

本研究旨在评估骶管硬膜外阻滞联合经椎间孔神经根阻滞治疗腰椎退行性疾病的成本效益。

方法

共纳入47例有腰腿痛症状的患者。在术前及术后1周使用视觉模拟量表(VAS)评估腰痛和腿痛情况。使用加法、除法和比例运算法则估算改善VAS上每个点所需的成本效益和价值。

结果

对于腰痛,术前评分范围为2至10分,平均为7.5±2.14(95%CI:6.8 - 8.1)。术后1周,这些评分范围为0至10分,平均为3.1±2.8(95%CI:2.3 - 4.0;p < 0.0001)。关于腿痛,术前评分范围为1至10分,平均为6.8±2.5(95%CI:6.1 - 7.4)。术后1周,这些评分范围为0至9分,平均为2.4±2.5(95%CI:1.8 - 3.1;p < 0.0001)。手术过程中使用材料的成本为214.72巴西雷亚尔。

结论

骶管硬膜外联合经椎间孔神经根阻滞是治疗腰椎退行性疾病患者的一种成本效益高的治疗方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81ec/11530217/2d9395c91fae/1809-4406-aob-32-05-e276189-f1.jpg

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