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一种超声引导下经椎间孔颈椎神经根注射并经透视验证的新方法:病例报告及技术说明

A Novel Approach of Ultrasound-Guided Transforaminal Cervical Nerve Root Injection With Fluoroscopic Validation: A Case Report and Technical Illustration.

作者信息

Wu Tsung Ju, Lee Chih-Wei, Lam King Hei Stanley, Hung Chen-Yu

机构信息

Regenerative Medicine, Reboot Clinics, Changhua, TWN.

Physical Medicine and Rehabilitation, Changhua Christian Hospital, Changhua, TWN.

出版信息

Cureus. 2024 Dec 1;16(12):e74937. doi: 10.7759/cureus.74937. eCollection 2024 Dec.

DOI:10.7759/cureus.74937
PMID:39744273
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11688572/
Abstract

Cervical radiculopathies are commonly treated with nerve root injections. This study presents a novel ultrasound (US)-guided cervical transforaminal injection technique using a curved transducer to enhance visualization of the anterior wall of the superior articular process and achieve successful epidural spread of injection. A 56-year-old patient with chronic C6 radiculopathy was treated using our US-guided approach with a combination of 5% dextrose and vitamin B12, leading to significant improvement in symptoms. Our approach demonstrated accurate needle placement and effective injectate spread to the epidural space while minimizing the risk of vascular injury. This technique offers reduced fluoroscopy usage time, potentially reducing radiation exposure and improving therapeutic outcomes in the management of cervical radiculopathy.

摘要

神经根型颈椎病通常采用神经根注射进行治疗。本研究提出了一种新型的超声(US)引导下的颈椎经椎间孔注射技术,该技术使用弯曲探头来增强对上关节突前壁的可视化,并实现注射剂在硬膜外的成功扩散。一名患有慢性C6神经根病的56岁患者采用我们的超声引导方法,联合使用5%葡萄糖和维生素B12进行治疗,症状得到了显著改善。我们的方法显示出准确的针放置以及注射剂有效扩散至硬膜外间隙,同时将血管损伤风险降至最低。该技术减少了透视使用时间,有可能减少辐射暴露并改善神经根型颈椎病治疗的疗效。

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本文引用的文献

1
Ultrasound-Guided Cervical Selective Nerve Root Block versus Fluoroscopy-Guided Interlaminar Epidural Injection for Cervical Radicular Pain: A Randomized, Prospective, Controlled Study.超声引导下颈椎选择性神经根阻滞与透视引导下椎板间硬膜外注射治疗神经根型颈椎病的随机、前瞻性对照研究
J Pers Med. 2024 Jul 4;14(7):721. doi: 10.3390/jpm14070721.
2
Ultrasound-Guided Perineural Vitamin B12 Injection for Brachial Plexus Injury: A Preliminary Study.超声引导下经皮维生素 B12 注射治疗臂丛神经损伤:初步研究。
Cell Transplant. 2023 Jan-Dec;32:9636897231167213. doi: 10.1177/09636897231167213.
3
Evaluating the Extent of Ultrasound-Guided Cervical Selective Nerve Root Block in the Lower Cervical Spine: Evidence Based on Computed Tomography Images.
评估超声引导下颈椎下段选择性神经根阻滞的范围:基于计算机断层扫描图像的证据
J Pain Res. 2023 Mar 6;16:669-676. doi: 10.2147/JPR.S399431. eCollection 2023.
4
Diagnosis and Treatment of Cervical Spondylotic Radiculopathy Using Selective Nerve Root Block (SNRB): Where are We Now?使用选择性神经根阻滞(SNRB)诊断和治疗神经根型颈椎病:我们目前的进展如何?
Pain Ther. 2022 Jun;11(2):341-357. doi: 10.1007/s40122-022-00357-1. Epub 2022 Feb 15.
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US-Guided Transforaminal Cervical Nerve Root Block: A Novel Lateral in-Plane Approach.美国引导经椎间孔颈椎神经根阻滞:一种新的侧入路平面内技术。
Pain Med. 2021 Sep 8;22(9):1940-1945. doi: 10.1093/pm/pnab008.
6
Cervical spine radiculopathy epidemiology: A systematic review.颈椎神经根病流行病学:系统评价。
Musculoskeletal Care. 2020 Dec;18(4):555-567. doi: 10.1002/msc.1498. Epub 2020 Jul 25.
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The safety and efficiency of performing cervical transforaminal epidural steroid injections under fluoroscopic control on an ambulatory/outpatient basis.在透视控制下进行门诊/日间经椎间孔硬膜外类固醇注射的安全性和有效性。
Eur Spine J. 2020 May;29(5):994-1000. doi: 10.1007/s00586-019-06147-2. Epub 2019 Sep 18.
8
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Eur Spine J. 2017 Feb;26(2):336-344. doi: 10.1007/s00586-016-4437-0. Epub 2016 Feb 12.
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