在 Endometriosis 继发的慢性盆腔疼痛中进行背部根系节刺激
Tiago da Silva Freitas1, Antonio Jorge Barbosa de Oliveira1, Stanley Golovac2
1Functional Neurosurgery - Syrian Lebanese Hospital, Brasilia, DF, Brazil; Functional Neurosurgery, Base Hospital, Brasilia, DF, Brazil.
Neuromodulation : journal of the International Neuromodulation Society
|December 27, 2024
概括
背部根结节刺激 (DRG-S) 在患有子宫内膜异位症的女性中显著改善了慢性盆腔疼痛. 这种治疗减少了疼痛评分和阿片类药物使用,提高了整体生活质量.
科学领域:
- 疼痛医学 医学 疼痛医学
- 神经调节是一种神经调节.
- 妇科疼痛管理 妇科疼痛管理
背景情况:
- 慢性盆腔疼痛 (CPP) 是复杂的,通常与子宫内膜异位症有关,需要多式治疗.
- 传统疗法和脊髓刺激 (SCS) 对耐火性CPP的成功程度有限.
- 背部根性腺刺激 (DRG-S) 正在探索与子宫内膜异位症相关的难治性CPP.
研究的目的:
- 评估双边L1和S2DRG-S在因子宫内膜异位症而导致难治的CPP患者的疗效.
- 评估疼痛强度,药物使用和生活质量的改善.
主要方法:
- 一个前性研究,对10名患有严重CPP的患者进行了二次性子宫内膜异位症的研究,这些患者对先前的治疗没有反应.
- 9名患者接受了永久的双边L1和S2DRG-S (每个患者4个线索).
- 通过视觉模拟量表 (VAS),阿片类药物消费和12个月的SF-12调查来衡量结果.
主要成果:
- 疼痛评分持续显著降低 (VAS 9±1.5 至 2±2.0, p=0.003). 疼痛评分持续显著降低 (VAS 9±1.5 至 2±2.0, p=0.003).
- 阿片类药物消费明显下降,四名患者完全停止使用 (p=0.046).
- 在SF-12物理 (60.2±7.8,p=0.006) 和心理 (45.9±2.76,p=0.01) 评分上有显著的改善.
结论:
- 双边L1和S2DRG-S为耐火性子宫内膜异位症相关的CPP提供了一个有前途的治疗选择.
- 该程序显示强大和持续改善疼痛,药物使用和生活质量.
- 对于复杂的骨盆疼痛病例,DRG-S代表了一种可行的神经调节策略.
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