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加强慢性背痛管理:超声-磁共振成像融合引导下椎旁神经阻滞的比较研究

Enhancing chronic back pain management: A comparative study of ultrasound-MRI fusion guidance for paravertebral nerve block.

作者信息

He Shuyao, Xu Yaona, Li Bo, Shi Ying

机构信息

Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.

Department of Digital Medicine, School of Biomedical Engineering and Medical Imaging, Third Military Medical University (Army Medical University), Chongqing, 400038, China.

出版信息

Open Med (Wars). 2025 Aug 19;20(1):20251147. doi: 10.1515/med-2025-1147. eCollection 2025.

Abstract

OBJECTIVE

This study examines the efficacy of ultrasound (US)-guided paravertebral nerve block (PVB) with and without MRI fusion for chronic back pain management.

METHODS

A retrospective analysis of 20 patients, split into US-MRI fusion-guided (IF group, = 10) and traditional US-guided (U group, = 10) PVB, was conducted. Pain intensity, gabapentin dosage, procedure duration, and treatment efficacy were compared using numerical rating scale (NRS) scores.

RESULTS

An hour after receiving treatment, the IF group showed a marked reduction in NRS scores (2.2 ± 0.9), significantly lower than those observed in the U group (2.5 ± 1.0; < 0.05). Nonetheless, the difference in average NRS scores between the groups was not statistically significant 7 days post-treatment (IF group, 3.5 ± 0.8; U group, 3.4 ± 1.3; > 0.05). The U group reported four instances of transient dizziness and diminished limb muscle strength, lasting between 30 and 90 min, which naturally resolved without intervention. No significant adverse effects were noted in the IF group.

CONCLUSIONS

Integrating US with MRI for PVB guidance emerges as a groundbreaking and efficacious strategy in chronic back pain treatment, showcasing significant improvements in safety and initial pain alleviation compared to the conventional use of US guidance alone.

摘要

目的

本研究探讨超声(US)引导下椎旁神经阻滞(PVB)联合或不联合MRI融合技术在慢性背痛治疗中的疗效。

方法

对20例患者进行回顾性分析,分为US-MRI融合引导组(IF组,n = 10)和传统US引导组(U组,n = 10)进行PVB。使用数字评分量表(NRS)评分比较疼痛强度、加巴喷丁剂量、手术持续时间和治疗效果。

结果

治疗后1小时,IF组NRS评分显著降低(2.2±0.9),明显低于U组(2.5±1.0;P<0.05)。然而,治疗后7天两组平均NRS评分差异无统计学意义(IF组,3.5±0.8;U组,3.4±1.3;P>0.05)。U组报告有4例出现短暂头晕和肢体肌肉力量减弱,持续30至90分钟,未经干预自然缓解。IF组未观察到明显不良反应。

结论

将US与MRI结合用于PVB引导是慢性背痛治疗中一种开创性的有效策略,与单独使用传统US引导相比,在安全性和初始疼痛缓解方面有显著改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f400/12413793/fd4ee21188d0/j_med-2025-1147-fig001.jpg

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