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小关节退变在经椎间孔硬膜外类固醇注射治疗成功中的作用：一项回顾性临床研究。

The role of facet joint degeneration in the treatment success of transforaminal epidural steroid injection: a retrospective clinical study.

作者信息

Sekizkardes Tutuncu Merve, Sencan Savas, Kurt Canan Bilekyigit, Kokar Serdar, Gunduz Osman Hakan

机构信息

Department of Physical Medicine and Rehabilitation, Division of Pain Medicine, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey.

Department of Physical Medicine and Rehabilitation, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey.

出版信息

Skeletal Radiol. 2025 Aug;54(8):1689-1696. doi: 10.1007/s00256-025-04868-8. Epub 2025 Jan 22.

DOI:10.1007/s00256-025-04868-8
PMID:39841173
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12174188/
Abstract

OBJECTIVE

Transforaminal epidural steroid injection (TFESI) is highly effective in alleviating radicular back pain. While predictive factors for TFESI treatment outcomes have been previously studied, there is a lack of data on the relationship between facet joint degeneration and TFESI efficacy. This study is aimed at studying the impact of facet joint degeneration on TFESI treatment outcomes for unilateral radicular pain.

DESIGN

A retrospective analysis was conducted on patients with unilateral radicular pain who underwent lumbosacral TFESI. Pain severity was assessed using the Numerical Rating Scale (NRS) at baseline, 1 h post-procedure, and 3 weeks post-procedure. Degree of facet joint degeneration was evaluated via MRI. Patients were categorized into two groups: low-grade facet joint degeneration group (group 1) and high-grade facet joint degeneration group (group 2).

RESULTS

A total of 147 patients were included in the study. NRS scores were significantly higher in group 2 compared to group 1 at the 3rd week follow-up. Treatment success, defined as a ≥ 50% reduction in NRS scores, was also significantly higher in group 1.

CONCLUSION

Facet joint degeneration adversely impacts the treatment success of TFESI. A comprehensive evaluation of facet joint pathologies prior to procedure planning is imperative for optimizing treatment outcomes.

摘要

目的

经椎间孔硬膜外类固醇注射（TFESI）在缓解神经根性背痛方面非常有效。虽然之前已经研究了TFESI治疗效果的预测因素，但关于小关节退变与TFESI疗效之间的关系的数据却很缺乏。本研究旨在探讨小关节退变对单侧神经根性疼痛TFESI治疗效果的影响。

设计

对接受腰骶部TFESI的单侧神经根性疼痛患者进行回顾性分析。在基线、术后1小时和术后3周使用数字评分量表（NRS）评估疼痛严重程度。通过MRI评估小关节退变程度。患者分为两组：轻度小关节退变组（第1组）和重度小关节退变组（第2组）。

结果

本研究共纳入147例患者。在第3周随访时，第2组的NRS评分显著高于第1组。治疗成功定义为NRS评分降低≥50%，第1组的治疗成功率也显著更高。

结论

小关节退变对TFESI的治疗成功产生不利影响。在进行手术规划之前，对小关节病变进行全面评估对于优化治疗效果至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93c8/12174188/e03c39ae3aa1/256_2025_4868_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93c8/12174188/b8403110210e/256_2025_4868_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93c8/12174188/e03c39ae3aa1/256_2025_4868_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93c8/12174188/b8403110210e/256_2025_4868_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/93c8/12174188/e03c39ae3aa1/256_2025_4868_Fig2_HTML.jpg

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本文引用的文献

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J Orthop. 2020 Apr 8;22:109-117. doi: 10.1016/j.jor.2020.03.058. eCollection 2020 Nov-Dec.
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At Least 5-Year Follow-up After Transforaminal Epidural Steroid Injection Due to Lumbar Radicular Pain Caused by Spinal Stenosis.腰椎管狭窄症引起的根性腰痛行经椎间孔硬膜外类固醇注射治疗后的至少 5 年随访。
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Predictive factors for treatment success of transforaminal epidural steroid injection in lumbar disc herniation-induced sciatica.经皮椎间孔入路腰椎间盘切除术治疗腰椎间盘突出症所致坐骨神经痛的疗效预测因素。
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The Effectiveness of Lumbar Transforaminal Injection of Steroid for the Treatment of Radicular Pain: A Comprehensive Review of the Published Data.腰椎经皮穿刺注射类固醇治疗根性疼痛的疗效：已发表数据的综合评价。
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