Liao Zhenlan, Zhou Yajing, Cao Wen
Department of Ultrasound, The First People's Hospital of Neijiang, Neijiang, People's Republic of China.
Department of Ultrasound Medicine, TongRen Hospital, Capital Medical University, Beijing, People's Republic of China.
J Pain Res. 2025 Jun 14;18:2973-2982. doi: 10.2147/JPR.S524917. eCollection 2025.
The aim of this retrospective study was to evaluate the effectiveness of ultrasound-guided hydrodissection of the C5 nerve root, in combination with prevertebral fascia incision, as a treatment for neurogenic thoracic outlet syndrome (NTOS).
Between January 2023 and January 2024, a total of 34 patients diagnosed with NTOS were enrolled in the treatment group, all of whom underwent ultrasound-guided hydrodissection of the C5 nerve root and prevertebral fascia incision. A control group consisting of 34 healthy participants was also included for comparative purposes. Preoperative and postoperative ultrasound measurements were taken at 1 and 6 weeks, including the thickness of the prevertebral fascia, the distance between the C5 nerve root and fascia, and the cross-sectional area (CSA) of the C5 nerve root. Pain intensity and functional status were assessed using the Visual Analog Scale (VAS) and Disabilities of the Arm, Shoulder, and Hand (DASH) scores.
Preoperative measurements in the NTOS group showed increased prevertebral fascia thickness (median: 0.1 mm [IQR 0.08-0.12]), reduced distance between the C5 nerve root and the fascia (median: 0.13 mm [IQR 0.10-0.16]), and a larger CSA of the C5 nerve root (median: 0.08 mm² [IQR 0.06-0.10]). Post-treatment, VAS scores significantly improved from a median of 7 (IQR 6-8) to 2 (IQR 2-3) at 1 week and remained stable at 6 weeks, while DASH scores improved from 85 (IQR 82-89) to 34 (IQR 31-36) at 1 week and 33 at 6 weeks.
Ultrasound-guided hydrodissection of the C5 nerve root, along with prevertebral fascia incision, is an effective, minimally invasive treatment for NTOS.
本回顾性研究旨在评估超声引导下C5神经根水分离联合椎前筋膜切开术治疗神经源性胸廓出口综合征（NTOS）的有效性。
2023年1月至2024年1月，治疗组共纳入34例诊断为NTOS的患者，所有患者均接受了超声引导下C5神经根水分离和椎前筋膜切开术。为作比较，还纳入了由34名健康参与者组成的对照组。在术前以及术后1周和6周进行超声测量，包括椎前筋膜厚度、C5神经根与筋膜之间的距离以及C5神经根的横截面积（CSA）。使用视觉模拟量表（VAS）和手臂、肩部和手部功能障碍（DASH）评分评估疼痛强度和功能状态。
NTOS组术前测量显示椎前筋膜厚度增加（中位数：0.1毫米[四分位间距0.08 - 0.12]），C5神经根与筋膜之间的距离减小（中位数：0.13毫米[四分位间距0.10 - 0.16]），C5神经根的CSA增大（中位数：0.08平方毫米[四分位间距0.06 - 0.10]）。治疗后，VAS评分在1周时从中位数7（四分位间距6 - 8）显著改善至2（四分位间距2 - 3），并在6周时保持稳定，而DASH评分在1周时从85（四分位间距82 - 89）改善至34（四分位间距31 - 36），在6周时为33。
超声引导下C5神经根水分离联合椎前筋膜切开术是治疗NTOS的一种有效、微创的方法。
