文章摘要
孙允龙,徐勇,刘其桃,等.经颈椎间孔类固醇激素注射治疗神经根性颈椎病的临床疗效观察.骨科,2019,10(3): 188-192.
经颈椎间孔类固醇激素注射治疗神经根性颈椎病的临床疗效观察
Clinical outcome of cervical transforaminal epidural steroids injection for the treatment of cervical spondylotic radiculopathy
投稿时间:2019-01-22  
DOI:10.3969/j.issn.1674-8573.2019.03.004
中文关键词: 经颈椎间孔类固醇激素注射  颈部疼痛  神经根性颈椎病  治疗结果
英文关键词: Cervical transforaminal epidural steroid injection  Cervicalgia  Cervical radiculopathy  Treatment outcome
基金项目:国家重点研发计划(2016YFB1101300)
作者单位E-mail
孙允龙 华中科技大学同济医学院附属同济医院骨科武汉 430030  
徐勇 华中科技大学同济医学院附属同济医院骨科武汉 430030  
刘其桃 华中科技大学同济医学院附属同济医院骨科武汉 430030  
吴巍 华中科技大学同济医学院附属同济医院骨科武汉 430030  
方忠 华中科技大学同济医学院附属同济医院骨科武汉 430030  
熊伟 华中科技大学同济医学院附属同济医院骨科武汉 430030  
李锋 华中科技大学同济医学院附属同济医院骨科武汉 430030 lifengmd@hust.edu.cn 
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中文摘要:
      目的 探讨X线引导下经颈椎间孔类固醇激素注射(cervical transforaminal epidural steroids injection, CTFESI)治疗由神经根性颈椎病所致慢性颈部疼痛的临床疗效。方法 回顾性分析2016年5月至2018年3月于我院门诊骨科治疗室经X线引导下行CTFESI治疗的47例慢性颈部疼痛病人的临床资料,将其纳入研究组;将同期采用牵引、按摩等保守治疗的56例慢性颈部疼痛病人纳入对照组。收集并比较两组病人治疗前后的疼痛视觉模拟量表(visual analogue score, VAS)评分、颈椎功能障碍指数(neck disability index, NDI),并利用Odom's评分计算两组病人的治疗有效率。结果 研究组病人均顺利完成注射,其中1例病人于术后出现瞳孔缩小、眼睑下垂等Honor综合征表现,2例病人出现疑似局部血肿症状,经按压、冰敷后症状好转,上述病人均经急诊室留观确认病情稳定后出院。治疗后6个月,研究组和对照组VAS评分分别为(1.96±1.23)分、(3.27±1.52)分,NDI分别为20.18%±1.83%、29.73%±3.57%,均较治疗前水平显著改善,且研究组优于对照组,两组间比较,差异具有统计学意义(P<0.05)。研究组的治疗总有效率为72.34%(34/47),对照组为51.79%(29/56),两组间比较,差异具有统计学意义(χ2=4.550,P=0.043)。结论 CTFESI治疗由神经根性颈椎病所致慢性颈部疼痛临床疗效好,是介于保守治疗与手术治疗之间的一种有效方法。
英文摘要:
      Objective To evaluate the clinical outcome of cervical transforaminal epidural steroids injection (CTFESI) for the treatment of cervical spondylotic radiculopathy. Methods The clinical data of 47 patients with chronic neck pain who underwent cluoroscopically-guided CTFESI treatment from May 2016 to March 2018 in our hospital were retrospectively analyzed and included in the treatment group. Other 56 patients with chronic neck pain who were treated with other conservative treatments were included in the control group. The visual analogue score (VAS) and the neck disability index (NDI) were collected and compared between the two groups. The Odom's score was used to calculate the treatment effectiveness of the two groups. Results All the patients in the treatment group successfully completed the injection. One patient developed Honor syndrome-like symptoms, and the symptoms of suspected local hematoma occurred in 2 patients. The symptoms were relieved after compression and ice application. After observation in the emergency room, the patient was confirmed to be stable and discharged. The remaining patients had no special discomfort. The postoperative VAS scores in the treatment group and the control group were 1.96±1.23 and 3.27±1.52 points, respectively, which were significantly better than those before treatment in two groups (P<0.05), and those in the treatment group were better than those in the control group (P<0.05). The postoperative NDI scores in the two groups were significantly lower than those pre-treatment, and those in the treatment group (20.18%±1.83%) were significantly lower than those in the control group (29.73%±3.57%) (P<0.05). At the last follow-up, the total effective rate in the treatment group was 72.34% (34/47), and that was 51.79% (29/56) in the control group (χ2=4.550, P=0.043). Conclusion CTFESI is an effective method for the treatment of cervical spondylotic radiculopathy. It is an effective method between conservative treatment and surgical treatment.
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