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首页> 外文期刊>Pain research & management: the journal of the Canadian Pain Society = journal de la socie?te? canadienne pour le traitement de la douleur >Ultrasound-Guided Selective Nerve Root Block versus Fluoroscopy-Guided Interlaminar Epidural Block versus Fluoroscopy-Guided Transforaminal Epidural Block for the Treatment of Radicular Pain in the Lower Cervical Spine: A Retrospective Comparative Study
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Ultrasound-Guided Selective Nerve Root Block versus Fluoroscopy-Guided Interlaminar Epidural Block versus Fluoroscopy-Guided Transforaminal Epidural Block for the Treatment of Radicular Pain in the Lower Cervical Spine: A Retrospective Comparative Study

机译：超声引导选择性神经根块与透视引导的层间硬膜外块与透视引导的跨界硬膜外嵌段块治疗下颈椎下颌疼痛：回顾性比较研究

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Background . Recently, ultrasound- (US-) guided selective nerve root block (SNRB) has been reported to have similar effects compared to fluoroscopy- (FL-) guided cervical epidural steroid injection (CESI). There is no published study comparing the therapeutic efficacy and safety of interlaminar- (IL-) CESI and transforaminal- (TF-) CESI with US-guided SNRB. Our retrospective study aimed to compare the mid-term effects and advantages of the US-guided SNRB, FL-guided IL-CESI, and TF-CESI for radicular pain in the lower cervical spine through assessment of pain relief and functional improvement. Methods . Patients with radicular pain in the lower cervical spine who received guided SNRB ( n =?44) or FL-guided IL ( n =?41) or TF-CESI ( n =?37) were included in this retrospective study. All procedures were performed using a FL or US. The complication frequencies during the procedures, adverse event, treatment effects, and functional improvement were compared at 1, 3, and 6 months after the last injection. Results . Both the Neck Disability Index (NDI) and Verbal Numeric Scale (VNS) scores showed improvements at 1, 3, and 6 months after the last injection in all groups, with no significant differences between groups P 0.05 . Furthermore, the treatment success rate at all time points was not significantly different between groups. Logistic regression analysis revealed that the injection method (US- or FL-guided), cause, sex, age, number of injections, and pain duration were not independent predictors of treatment success. Blood was aspirated before injection in 7% ( n =?3), 14% ( n =?6), and 0% patients in the FL-guided IL, TF, and US-guided groups, respectively. In 2 patients of FL-guided IL and 7 of FL-guided TF group, intravascular contrast spread was noted during injection. Conclusions . Our results suggest that, compared with FL-guided IL and TF-CESI, US-guided SNRB has a low intravascular injection rate; it is unlikely that serious complications will occur. Also, US-guided SNRB requires a shorter administration duration while providing similar pain relief and functional improvements. Therefore, for the treatment of patients with lower cervical radicular pain, US-guided SNRB should be considered as a prior epidural steroid injection.
机译：背景 。最近，据报道，与荧光透视（FL-）引导的宫颈硬样物注射（CESI）相比，据报道，超声波（US-）引导的选择性神经根嵌段（SNRB）具有类似的效果。没有公布的研究比较了Interlaminar-（IL-）CESI和Transforaminal-（TF-）Cesi与美国引导的SNRB的治疗效果和安全性。我们的回顾性研究旨在通过评估疼痛缓解和功能改进，比较美国引导的SNRB，FL引导的IL-CESI和TF-CESI的中期效果和优点，用于降低宫颈脊柱的自然疼痛。方法 。在该回顾性研究中包括患者接受引导SnRB（n =Δ44）或流动的IL（n =Δ41）或TF-CESI（n =Δ3）的下颈椎疼痛的患者。所有程序都使用FL或我们进行。在最后一次注射后的1,3和6个月比较了程序，不良事件，治疗效果和功能性改进期间的并发症频率。结果 。颈部残疾指数（NDI）和口头数值（VNS）分数均在所有组上注于最后一次注射后的1,3和6个月内显示出改善，群体P <0.05之间无显着差异。此外，组之间的治疗成功率在组之间没有显着差异。逻辑回归分析显示，注射方法（US-或FL引导），原因，性别，年龄，注射次数，疼痛持续时间不是独立的治疗成功预测因子。在注射到7％（n =β3），14％（n =β6）和0％患者中分别在流动的IL，TF和美国引导群体中吸出血液。在2例FL引导的IL和7患者中，在注射期间注意到血管内对比度。结论。我们的研究结果表明，与流动IL和TF-CESI相比，美国引导的SNRB具有较低的血管内注射率;它不太可能发生严重的并发症。此外，美国引导的SNRB需要更短的给药持续时间，同时提供类似的疼痛缓解和功能改进。因此，为了治疗宫颈自治疼痛较低的患者，美国引导的SNRB应被视为先前硬膜外类固醇注射。

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