文章摘要
吴巍,徐勇,孙允龙,廖晖.X线引导下选择性颈神经根阻滞在神经根型颈椎病诊疗中的应用及评价.骨科,2019,10(5):418-422
X线引导下选择性颈神经根阻滞在神经根型颈椎病诊疗中的应用及评价
Diagnostic and therapeutic application and evaluation of fluoroscopy-guided selective nerve root blocks for cervical radiculopathy
投稿时间:2019-07-29  
DOI:10.3969/j.issn.1674-8573.2019.05.010
中文关键词: 选择性颈神经根阻滞  X线透视引导  神经根型颈椎病  诊断与治疗
英文关键词: Selective nerve root blocks  Fluoroscopy-guided  Cervical radiculopathy  Diagnosis and treatment
基金项目:国家自然科学基金(81401762)
作者单位E-mail
吴巍 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  
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  
廖晖 华中科技大学同济医学院附属同济医院骨科武汉 430030 liaohui0001@yahoo.com 
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中文摘要:
      目的 探讨X线引导下选择性颈神经根阻滞(selective nerve root blocks, SNRBs)在神经根型颈椎病诊疗中应用的安全性及价值。方法 回顾性分析2014年3月至2019年2月我院收治并行X线引导下SNRBs进行神经根型颈椎病诊断与治疗的病人67例,其中52例诊断为神经根型颈椎病病人接受神经根阻滞治疗,15例经阻滞确诊为神经根型颈椎病或确定责任节段并接受治疗。记录所有病人临床资料、影像学资料、操作是否成功、手术时间、术中并发症发生情况、术前和术后各随访时间点疼痛视觉模拟量表(visual analogue scale, VAS)评分及颈椎功能障碍指数(neck disability index, NDI)。结果 所有病人均操作成功,2例病人分别出现上肢乏力和头晕,于术后6 h和4 h后恢复;病人阻滞后即时、3个月及末次随访时VAS评分及NDI评分均较阻滞前有所降低,差异均具有统计学意义(P均<0.05)。末次随访时,63例病人症状均获得明显缓解,获得满意保守治疗效果;4例病人后转行手术治疗。结论 X线引导下SNRBs操作简单、安全,可用于辅助诊断神经根型颈椎病,确认责任节段;并可作为神经根型颈椎病的一种有效的治疗方式。
英文摘要:
      Objective To study the safety and applied value of fluoroscopy-guided selective nerve root blocks (SNRBs) for the diagnosis and treatment of cervical radiculopathy. Methods A retrospective analysis of 67 cases who received fluoroscopy-guided SNRBs for the diagnosis and treatment of cervical radiculopathy in our hospital between March 2014 to February 2019 was conducted. Of these cases, 52 who were diagnosed as cervical radiculopathy underwent therapeutic SNRBs, and rest 15 were given SNRBs to identify exactly the symptomatic level(s). The clinical characteristics, imaging data, success or failure of operation, operating time and complications were recorded. The visual analogue scale (VAS) and the neck disability index (NDI) preoperation and at each follow-up point were collected. Results The operative procedures were conducted successfully in all the patients. Weakness of upper limbs and dizziness occurred in 2 cases, and the symptoms relieved 6 and 4 h after injections, respectively. The postoperative VAS and NDI scores were significantly decreased as compared with preoperative values (P<0.05). At latest follow-up, the symptoms in 63 patients were improved obviously, and the SNRBs treatment was effective. Four cases were converted to the surgical operation. Conclusion The fluoroscopy-guided SNRBs process is simple and safe in operation, and it could be used as an effective method for treating cervical radicular pain and determine the responsible level(s).
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