周围神经刺激用于治疗慢性膝盖疼痛
Anton Früh1,2, Tarik Alp Sargut1, Abdelhalim Hussein3
1Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, and Humboldt-Universität Zu Berlin, Berlin Institute of Health, Berlin, Germany.
Scientific reports
|September 20, 2023
概括
外部供电的外周神经刺激 (PNS) 为慢性膝关节疼痛提供了安全有效的治疗方法,显著减少疼痛和阿片类药物使用. 这种微创的技术准了神经,改善了生活质量和睡眠.
科学领域:
- 神经学 神经学
- 疼痛管理 疼痛管理
- 生物医学工程 生物医学工程
背景情况:
- 人口老龄化增加了慢性退行性膝关节病理.
- 慢性手术后膝盖疼痛影响16-20%的受试者,治疗选择有限.
- 周围神经刺激 (PNS) 是有前途的,但面临着远端肢体向的挑战.
研究的目的:
- 评估外部供电的PNS对慢性难治膝痛的安全性和有效性.
- 通过地标导向植入技术准沙神经分支.
- 评估疼痛,生活质量,睡眠和情绪的改善.
主要方法:
- 对33名接受标志性导向,外部驱动的神经分支PNS的患者的回顾性分析.
- 使用外部供电系统来防止的迁移.
- 疼痛强度用数值评分尺度测量;生活质量,睡眠和情绪使用SF-36,PSQI和GDS进行评估.
主要成果:
- 25名患者完成了这项研究,在8名患者被解释后 (6名受益不足,2名感染).
- 在疼痛强度 (休息和运动),生活质量,睡眠质量和情绪方面报告了显著的改善.
- 治疗后观察到阿片类药物摄入量大幅减少.
结论:
- 外部供电的PNS准沙神经分支是一种安全,选择性和简单的治疗慢性膝关节疼痛的技术.
- 里程碑式导向植入比脊髓或背部根结节刺激 (DRGS) 具有较低的并发症率,侵袭性较小.
- 短期结果是有希望的,显示显著的疼痛和阿片类药物减少; 长期结果正在等待.
相关概念视频
01:29Blood and Nerve Supply to the Bones
Bones are dynamic organs that require a rich supply of oxygen and nutrients. Around 5% to 10% of the cardiac output supplies blood to the bones. A typical long bone has three main sources: the nutrient artery, the metaphyseal and epiphyseal arteries, and the periosteal arteries.
Nutrient Artery
The nutrient artery is the main blood vessel that enters the diaphysis via the nutrient foramen. While most long bones have only one nutrient foramen, large bones, such as the femur, may have two. This...
Nutrient Artery
The nutrient artery is the main blood vessel that enters the diaphysis via the nutrient foramen. While most long bones have only one nutrient foramen, large bones, such as the femur, may have two. This...
01:31Skeletal Muscle Relaxants: Therapeutic Uses
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx as...