潜在的S1神经根块与神经关节注射相关
Andrew Ng1, Jesse Lou1, Dajie Wang1
1Department of Anesthesiology Jefferson Pain Center Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Pain research & management
|August 7, 2024
概括
圣关节注射可以通过影响S1神经根,导致腿部暂时麻木. 使用较少的局部麻醉剂可能会降低这种风险,并提高腰部疼痛的诊断准确度.
科学领域:
- 疼痛管理 疼痛管理
- 放射学 放射学是一门学科.
- 人体解剖学 解剖学 解剖学
背景情况:
- 关节 (SI) 关节功能障碍是腰部疼痛的常见原因之一.
- 诊断SI关节疼痛是一项挑战,SI关节注射是诊断和治疗的黄金标准.
- 一个已知的SI关节注射的并发症是暂时的腿部麻木和软弱.
研究的目的:
- 在注射过程中评估SI关节解剖学和对比流动.
- 了解局部麻醉剂如何影响神经根,导致临时腿部症状.
- 为了将成像发现与潜在的神经并发症相关联.
主要方法:
- 一个学术医疗中心的回顾案例系列设计.
- 对接受SI关节注射3D圆束CT (CBCT) 光镜的患者的审查.
- 分析CBCT图像以评估SI关节和周围结构内的对比分布.
主要成果:
- 分析了27名患者 (平均年龄56岁).
- 14.8%的患者显示对比物扩散到S1后部神经孔.
- 85.2%的患者的对比度仅限于SI关节.
结论:
- 局部麻醉剂的度和体积较低,可能会降低S1神经根和外周道堵塞的风险.
- 考虑S1神经病理对于SI关节疼痛的准确诊断很重要.
- 优化SI关节注射技术可以提高诊断特异性,并最大限度地减少并发症.
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