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射频毁损背根神经节治疗颈臂痛:一项前瞻性双盲随机研究

Radiofrequency lesion adjacent to the dorsal root ganglion for cervicobrachial pain: a prospective double blind randomized study.

作者信息

van Kleef M, Liem L, Lousberg R, Barendse G, Kessels F, Sluijter M

机构信息

Department of Anaesthesiology, University Hospital of Maastricht, The Netherlands.

出版信息

Neurosurgery. 1996 Jun;38(6):1127-31; discussion 1131-2. doi: 10.1097/00006123-199606000-00013.

Abstract

Each of 20 consecutive patients with a history of at least 1 year of intractable chronic cervicobrachial pain was randomly assigned to one of two treatment groups. The pretreatment investigation included at least three diagnostic segmental nerve blocks in each patient. Each patient in Group 1 received a 67 degrees C radiofrequency lesion adjacent to the dorsal root ganglion. The patients in Group II were treated in an identical manner as those in Group I, except that no actual radiofrequency lesion was made. Neither the therapist nor the patients were aware of the treatment group assignment. All patients were questioned about their pain experience 1 week before and 8 weeks after the procedure. The following tests were used in evaluating patient response: Visual Analogue Scale (VAS); McGill Pain Questionnaire, Dutch Language Version (MPQ-DLV); and Multidimensional Pain Inventory, Dutch Language Version (MPI-DLV). These tests showed that 8 weeks after the procedure, there was a significant number of "successful" patients in Group I compared to Group II (P = 0.0027); there was a significant reduction in VAS score (P < 0.01) and also in parameters measured with MPQ-DLV and MPI-DLV in Group I. This study indicates that a 67 degrees C radiofrequency lesion adjacent to the dorsal root ganglion can result in a significant alleviation of pain in chronic cervicobrachial pain.

摘要

连续20例有至少1年顽固性慢性颈臂痛病史的患者被随机分配到两个治疗组中的一组。预处理调查包括对每位患者进行至少三次诊断性节段性神经阻滞。第一组的每位患者在背根神经节附近接受67摄氏度的射频损伤。第二组患者的治疗方式与第一组相同,只是未进行实际的射频损伤。治疗师和患者均不知道治疗组的分配情况。所有患者在手术前1周和手术后8周均被询问其疼痛体验。在评估患者反应时使用了以下测试:视觉模拟量表(VAS);麦吉尔疼痛问卷荷兰语版(MPQ-DLV);以及多维疼痛量表荷兰语版(MPI-DLV)。这些测试表明,与第二组相比,第一组在手术后8周有大量“成功”患者(P = 0.0027);第一组的VAS评分显著降低(P < 0.01),并且MPQ-DLV和MPI-DLV测量的参数也显著降低。本研究表明,背根神经节附近67摄氏度的射频损伤可显著减轻慢性颈臂痛患者的疼痛。

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