6. 6. 6. 这是一个很大的问题. 持续性脊柱疼痛综合征2型
Johan van de Minkelis1,2, Laurens Peene3, Steven P Cohen4,5
1Anesthesiology and Pain Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.
概括
持续脊柱疼痛综合征2型 (PSPS-2) 诊断依赖于患者病史,检查和成像. 当保守方法失败时,干预性治疗,如脉冲射频,粘合溶解和脊髓刺激,显示出有希望的结果.
科学领域:
- 神经外科 神经外科
- 疼痛管理 疼痛管理
- 脊柱外科手术 脊柱外科手术
背景情况:
- 持续性脊柱疼痛综合征2型 (PSPS-2),以前称为失败的背部手术综合征,涉及脊柱手术后的慢性疼痛.
- 病因学包括程序错误,技术故障,生物力学变化和并发症.
- 诊断包括患者病史,体检和医学成像.
研究的目的:
- 审查和总结有关PSPS-2诊断和治疗的当前文献.
- 评估针对PSPS-2的各种治疗干预措施的证据.
主要方法:
- 关于PSPS-2诊断和治疗的综合文献搜索.
- 综合和总结检索的研究.
主要成果:
- 保守治疗 (运动,治疗) 对PSPS-2疗效的证据质量不佳.
- 药理治疗证据非常有限.
- 干预方案,如脉冲射频 (PRF),外周粘合溶解和脊柱内镜显示潜在的好处.
- 脊髓刺激 (SCS) 对于神经病关节疼痛和在选定的PSPS-2患者中潜在的轴痛是有效的.
结论:
- 通过临床评估和成像来确立PSPS-2诊断.
- 保守干预缺乏强有力的证据.
- PRF,粘合溶解和SCS提供了更高的证据水平和安全性,在保守治疗失败后需要考虑.
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