Dong Minghui, He Bo, Liu Chengxin, Han Hao, Na Jian, Zhang Xiaodong, Zhu Gengyao, Bu Jinhui, Liu Guangwang
Xuzhou Central Hospital, The Affiliated Xuzhou Clinical College of Xuzhou Medical University, Xuzhou, Jiangsu, China.
Department of Orthopedic Surgery, XuZhou Central Hospital, XuZhou Clinical School of Xuzhou Medical University, Xuzhou, China.
Pain Manag. 2024 Dec;14(12):619-624. doi: 10.1080/17581869.2024.2439236. Epub 2024 Dec 11.
This pilot case series evaluated the feasibility and effectiveness of using endoscopic radiofrequency ablation (RFA) of the articular branch of the anterior obturator nerve under endoscopic and fluoroscopic guidance for controlling pain in patients with osteonecrosis of the femoral head (ONFH).
Data on 11 consecutive patients were collected with ONFH underwent endoscopic RFA of the anterior obturator nerve. Electromyography (EMG) examination was performed preoperatively and postoperatively. Visual Analogue Scale (VAS) scores, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, and analgesic usage were recorded preoperatively, on the day of surgery, and at 1, 3, and 6 months postoperatively.
The study included 5 males and 6 females, aged 45 to 91 years (mean age: 70.4 ± 14.6 years), with an average BMI of 29.5. All patients completed a minimum of 6 months of follow-up. Postoperative EMG showed no muscle damage. VAS and WOMAC scores demonstrated significant improvement, with reduced pain, stiffness, and improved hip function. Oral analgesic use also decreased.
Endoscopic RFA of the anterior obturator nerve effectively reduces pain and improves function in ONFH patients over 6 months. Further studies are needed to confirm long-term outcomes.
本前瞻性病例系列评估了在内镜和透视引导下，使用内镜射频消融（RFA）闭孔前神经关节支来控制股骨头坏死（ONFH）患者疼痛的可行性和有效性。
收集了11例连续接受闭孔前神经内镜RFA的ONFH患者的数据。术前和术后进行了肌电图（EMG）检查。记录术前、手术当天以及术后1、3和6个月时的视觉模拟量表（VAS）评分、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分以及镇痛药物使用情况。
该研究纳入了5名男性和6名女性，年龄在45至91岁之间（平均年龄：70.4±14.6岁），平均体重指数为29.5。所有患者均完成了至少6个月的随访。术后EMG显示无肌肉损伤。VAS和WOMAC评分均有显著改善，疼痛减轻、僵硬缓解，髋关节功能改善。口服镇痛药的使用也减少了。
闭孔前神经内镜RFA在6个月内可有效减轻ONFH患者的疼痛并改善其功能。需要进一步研究以确认长期疗效。
