骨内基础脊椎神经切除:来自三项前性临床试验的5年综合分析
Jad G Khalil1, Eeric Truumees2, Kevin Macadaeg3,4
1Orthopaedic Surgery, Oakland University, William Beaumont School of Medicine, Department of Orthopaedic Surgery, Beaumont University Hospital, 3811 West 13 Mile Rd, Royal Oak, MI, 48073, USA.
Interventional pain medicine
|January 6, 2025
概括
基础脊髓神经的骨内射频切除 (BVNA) 显著减少了慢性腰部疼痛患者的疼痛,并改善了五年内患者的功能. 这种治疗证明了强大的安全性,具有持久的长期益处.
科学领域:
- 疼痛管理 疼痛管理
- 干预性放射学 干预性放射学
- 脊柱外科手术 脊柱外科手术
背景情况:
- 脊椎性疼痛是慢性腰部疼痛 (CLBP) 的原因,起源于受损的脊椎末端板,由基础脊椎神经 (BVN) 传播.
- 磁力共振成像 (MRI) 上的模态变化 (MC) 表明末端板损伤,将其分类为1型或2型.
- 骨内射频移除BVN (BVNA) 是一种治疗脊椎性疼痛的方法,其临床影响和安全性先前在前性试验中得到证实.
研究的目的:
- 报告来自三个不同的临床试验的基础脊椎神经切除 (BVNA) 的五年总结结果.
- 评估BVNA在患有脊椎性疼痛的患者的长期安全性和有效性.
主要方法:
- 来自三项前性,开放式,单臂的BVNA治疗后续研究的数据.
- 分析包括249名参与者,具有基线和五年随访数据,评估奥斯威斯特残疾指数 (ODI) 和数值疼痛得分 (NPS).
- 统计分析采用对对的t测试,其次要结果包括响应率,患者满意度,不良事件和医疗保健利用率.
主要成果:
- 五年后,与基线相比,NPS (平均下降4.32) 和ODI (平均下降28.0) 显著改善.
- 32.1%的患者报告没有疼痛 (NPS=0),72.7%的患者总体有所改善,68.7%的患者恢复了CLBP前的活动水平.
- 阿片类药物的使用减少了65.2%,脊髓注射减少了58.1%,并且没有报告与设备相关的严重不良事件.
结论:
- 骨内BVNA是一种安全有效的脊椎性疼痛治疗方法,可显著和持久地改善疼痛和功能,长达五年.
- BVNA导致阿片类药物消费大幅减少,需要进一步的脊柱干预.
- 该程序表现出强大的安全性,治疗疼痛源的医疗保健利用率低,支持其长期可行性.
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