摘要
目的观察比较脊神经背支内侧支射频损毁和单纯神经阻滞治疗小关节源性下腰痛的效果,评估射频神经损毁的疗效和安全性。方法影像学检查显示腰椎小关节退行性变、主诉下腰痛向臀部和/或大腿放射的患者56例,分为脊神经背支内侧支神经阻滞组(medial branch block,MBB,n=32)和射频损毁组(radiofrequency,RF,n=24)。结果治疗后4周RF组疼痛缓解的成功率(79.17%)明显高于MBB组(68.75%)(P＜0.05)。36周后两组疼痛复发的病例百分比无明显差异(P＞0.05),但是36周内疼痛复发患者的疼痛缓解持续时间RF组(31±16.5)周明显长于MBB组(17.4±8.6)周(P＜0.05)。RF组少数患者治疗后2周内可能出现局部麻木、不适,甚至疼痛加剧,2周后几乎完全缓解。结论与单纯神经阻滞相比,脊神经背支内侧支射频损毁治疗小关节源性下腰痛具有疗效好、持续时间长的优点,而且并发症少。
Objective To compare the effectiveness of lumbar medial branch block of dorsal remi and neurotomy by radiofrequency at the same points, and evaluate the safety of radiofrequency for low back pain from facet joint degeneration. Methods Fifty six patients with low back pain caused by facet joint degeneration were randomized divided into 2 groups, medial branch block （ MBB, n = 32） with bupivacaine ＋ diprospan and radiofrequency （ RF, n = 24 ） with parameter of 80℃/90 s after sensory and motor test. Results The successful rate of RF group in 4 weeks was higher than that of MBB group （P 〈0.05）. The effectiveness of RF lasted longer than MBB did. However, the rate of success in MBB group was the same as RF group. Some cases in RF group felt numb and painful which were gone 2 weeks later. Conclusion Compared with MBB, RF could relieve low back pain from facet joint better and longer, with few complications.
出处
《实用疼痛学杂志》
2006年第3期138-141,共4页
Pain Clinic Journal
关键词
疼痛
治疗
神经传导阻滞
导管消融术
射频
腰痛
Pain
Therapy
Nerve block
Catheter ablation, Radiofrequency
Back pain
