Jain Anuj, Jithin K J, Kumar Harish, Sarawagi Radha, Kaushal Ashutosh, Barasker Swapnil Kumar
Department of Anesthesiology, All India Institute of Medical Science, Saket Nagar, Bhopal, Madhya Pradesh, 462020, India.
Department of Radiodiagnosis, All India Institute of Medical Science, Saket Nagar, Bhopal, Madhya Pradesh, 462020, India.
Interv Pain Med. 2025 Apr 10;4(2):100582. doi: 10.1016/j.inpm.2025.100582. eCollection 2025 Jun.
Chronic shoulder pain is a common musculoskeletal complaint. This study evaluates the effectiveness of fluoroscopy-guided suprascapular (SSN) and subscapular (SCN) articular branch blocks in managing chronic shoulder pain. The primary objective was to assess pain relief using a numerical rating scale (NRS) and functional improvement using Shoulder Pain and Disability Index (SPADI) over 12 weeks.
This prospective, single-arm observational study included 70 adults with chronic shoulder pain (≥3 months) meeting predefined criteria. All patients underwent fluoroscopy-guided SSN and SCN articular branch blocks with bupivacaine (2 ml, 0.5 %) and triamcinolone (0.5 ml, 20 mg) per site. NRS and SPADI were recorded at baseline and biweekly for 12 weeks. Secondary outcomes included range of motion (ROM) improvements and night pain resolution. Statistical analysis involved repeated measures ANOVA for normally distributed data and non-parametric tests for skewed data (p < 0.05 considered significant).
At 12 weeks, 78 % of patients achieved ≥50 % pain reduction. Mean NRS decreased from 7.6 ± 1.1 to 3.9 ± 1.1, while SPADI pain and disability scores improved by 57.1 % and 57.4 %, respectively (p < 0.001). Night pain resolved in all affected patients within two weeks. Repeated measures ANOVA confirmed significant improvements in pain and disability scores (p < 0.001). Mean lateral abduction improved by 29° (95 % CI: 22.8°-35.2°, p < 0.001).
Fluoroscopy-guided SSN and SCN articular branch blocks provide significant pain relief and functional improvement in chronic shoulder pain, offering a potential alternative to intra-articular injections or surgery in select patients.
慢性肩部疼痛是一种常见的肌肉骨骼疾病。本研究评估了在X线透视引导下肩胛上神经(SSN)和肩胛下神经(SCN)关节支阻滞治疗慢性肩部疼痛的有效性。主要目的是使用数字评定量表(NRS)评估疼痛缓解情况,并使用肩痛和功能障碍指数(SPADI)评估12周内的功能改善情况。
这项前瞻性单臂观察性研究纳入了70名符合预定义标准的慢性肩部疼痛(≥3个月)成人患者。所有患者均在X线透视引导下接受了SSN和SCN关节支阻滞,每个部位注射布比卡因(2毫升,0.5%)和曲安奈德(0.5毫升,20毫克)。在基线时以及之后的12周内每两周记录一次NRS和SPADI。次要结局包括活动范围(ROM)改善和夜间疼痛缓解。统计分析包括对正态分布数据进行重复测量方差分析,对偏态数据进行非参数检验(p<0.05认为具有统计学意义)。
在12周时,78%的患者疼痛减轻≥50%。平均NRS从7.6±1.1降至3.9±1.1,而SPADI疼痛和功能障碍评分分别提高了57.1%和57.4%(p<0.001)。所有受影响患者的夜间疼痛在两周内缓解。重复测量方差分析证实疼痛和功能障碍评分有显著改善(p<0.001)。平均外展改善了29°(95%CI:22.8°-35.2°,p<0.001)。
在X线透视引导下进行SSN和SCN关节支阻滞可显著缓解慢性肩部疼痛并改善功能,为部分患者提供了关节内注射或手术之外的潜在替代方案。