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无手术的中西医结合疗法治疗椎动脉襻形成所致亚急性放射性疼痛:一例报告及文献综述

Integrative Korean medicine treatment without surgery for the management of subacute radiating pain attributed to vertebral artery loop formation: A case report and literature review.

作者信息

Yun Jung Min, Go Dong Hyun, Lee Sook-Hyun

机构信息

Department of Korean Medicine Rehabilitation, Jaseng Hospital of Korean Medicine, Gangnam-gu, Seoul, Republic of Korea.

Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea.

出版信息

Medicine (Baltimore). 2025 Feb 28;104(9):e39483. doi: 10.1097/MD.0000000000039483.

Abstract

RATIONALE

Vertebral artery loop formation (VALF) compresses the adjacent cervical nerve root, resulting in cervical radiculopathy at the affected level. Neurosurgical interventions for anatomical separation are typically employed to relieve the symptoms, regardless of their duration. We herein report the management of the subacute symptoms of a rare case of cervical radiculopathy attributed to VALF using integrative Korean medicine (iKM) treatment without surgery.

PATIENT CONCERNS

A 54-year-old male patient presenting with a chief complaint of headache radiating to the posterior cervical and right scapular regions was treated with a 4-day program of inpatient care.

DIAGNOSES

Based on the findings of the cervical spine magnetic resonance imaging, the patient was diagnosed with VALF on the right side at the C3/C4 level.

INTERVENTIONS

He underwent iKM treatment comprising acupuncture, pharmacopuncture, Chuna therapy, and herbal medicine.

OUTCOMES

Significant improvement was noted in the patient's condition (neck pain Numeric Rating Scale scores of 5, 4, and 1; Neck Disability Index scores of 35.56, 20, and 4; and EuroQol 5-dimension index scores of 0.754, 0.787, and 0.862 at admission, discharge, and the 2-month follow-up, respectively; Patient Global Impression of Change scores of 3 and 1 at discharge and the 2-month follow-up, respectively).

LESSONS

This case report suggests that iKM treatment may be effective for subacute VALF symptoms without requiring surgery.

摘要

理论依据

椎动脉袢形成(VALF)压迫相邻的颈神经根,导致受累节段出现颈神经根病。无论症状持续时间长短,通常采用神经外科手术进行解剖分离以缓解症状。我们在此报告了一例罕见的因VALF导致的颈神经根病亚急性症状的治疗案例,采用了韩国传统医学(iKM)综合治疗,未进行手术。

患者情况

一名54岁男性患者,主要症状为头痛,放射至颈后部和右肩胛区,接受了为期4天的住院治疗。

诊断

根据颈椎磁共振成像结果,患者被诊断为右侧C3/C4水平的VALF。

干预措施

他接受了iKM治疗,包括针灸、药针、推拿疗法和草药治疗。

结果

患者病情有显著改善(入院时、出院时和2个月随访时的颈部疼痛数字评定量表评分分别为5、4和1;颈部功能障碍指数评分分别为35.56、20和4;欧洲五维健康量表指数评分分别为0.754、0.787和0.862;出院时和2个月随访时的患者整体改善印象评分分别为3和1)。

经验教训

本病例报告表明,iKM治疗对于VALF亚急性症状可能有效,且无需手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f081/11875575/cf94b57a7143/medi-104-e39483-g001.jpg

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