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磁共振成像引导下神经松解术治疗慢性难治性膝关节疼痛:一例报告

MRI-guided neurolysis for the treatment of chronic refractory knee pain: a case report.

作者信息

Marka Alexander W, Strenzke Maximillian, Weiss Kilian, Karampinos Dimitrios C, Woertler Klaus, Herbort Mirco, Befrui Nima, Finck Tom

机构信息

Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.

Philips GmbH, Röntgenstrasse 22, 22335, Hamburg, Germany.

出版信息

Skeletal Radiol. 2025 Jun;54(6):1353-1357. doi: 10.1007/s00256-024-04819-9. Epub 2024 Nov 12.

Abstract

Chronic refractory pain poses a significant challenge in knee joint pathologies, especially after exhaustion of conservative, arthroscopic, and endoprosthetic therapy options. This case report illustrates an innovative approach using MRI-assisted chemical neurolysis of a genicular nerve to manage persistent knee pain after arthroscopy. A 62-year-old male patient with chronic refractory knee pain, primarily localized at the inferomedial part of the knee, underwent high-resolution MRI to visualize the genicular nerves. This allowed for targeted ethanol-based neurolysis of the inferomedial genicular nerve. Following the procedure, the patient experienced substantial pain reduction for the follow-up duration of 4 months. The successful use of MRI-assisted chemical neurolysis offers a promising alternative treatment for patients with refractory knee pain, providing long-lasting pain relief without major side effects. This technique has the potential to improve the quality of life for patients suffering from chronic knee pain While these initial results are encouraging, it is important to note that further research, including both short-term and long-term studies, as well as randomized controlled trials, is warranted to establish the efficacy and safety of this treatment method in broader populations before it can be considered for routine incorporation into pain management practices.

摘要

慢性难治性疼痛在膝关节病变中构成了重大挑战,尤其是在保守治疗、关节镜治疗和人工关节置换治疗方案均无效之后。本病例报告展示了一种创新方法,即使用MRI辅助的膝神经化学性神经溶解术来处理关节镜检查后持续存在的膝关节疼痛。一名62岁男性患者,患有慢性难治性膝关节疼痛,主要位于膝关节的内下部分,接受了高分辨率MRI检查以可视化膝神经。这使得能够对膝内下神经进行靶向乙醇神经溶解术。术后,患者在4个月的随访期间疼痛大幅减轻。MRI辅助化学性神经溶解术的成功应用为难治性膝关节疼痛患者提供了一种有前景的替代治疗方法,可提供持久的疼痛缓解且无重大副作用。该技术有可能改善慢性膝关节疼痛患者的生活质量。虽然这些初步结果令人鼓舞,但需要注意的是,在将这种治疗方法常规纳入疼痛管理实践之前,有必要进行进一步研究,包括短期和长期研究以及随机对照试验,以确定其在更广泛人群中的疗效和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ab2/12000193/a3e00b3c40de/256_2024_4819_Fig1_HTML.jpg

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