对于慢性腰痛患者的成像考虑:一个案例报告
Kennedy Kirkpatrick1, Jay D Shah1, Krishna Shah1
1Dept. of Anesthesiology, Baylor College of Medicine, Houston, TX.
Pain medicine case reports
|May 7, 2025
概括
脊髓刺激 (SCS) 可能不适合所有慢性腰痛患者. 全面的成像和临床评估对于确定SCS候选人至关重要,特别是在失败的背部手术后.
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:
- 腰部疼痛是全球重大残疾之一.
- 脊髓刺激 (SCS) 是美国食品和药物管理局批准用于难以治愈的背痛,特别是在手术后.
- 在多次腰部手术后患有持续根部疼痛的患者被考虑用于SCS.
研究的目的:
- 介绍一个案例,突出彻底的诊断评估在慢性腰部疼痛管理的重要性.
- 强调需要量身定制的SCS候选人评估.
- 倡导在背部手术失败的患者中仔细考虑成像.
主要方法:
- 评估了一名43岁的女性患者,在三次腰部手术后持续的右侧根部疼痛.
- 进行了诊断成像,包括带有和没有对比度的MRI.
- 在成像显示了复发性圆盘之后,该患者被考虑进行腰椎脊柱融合 (前腰椎体融合).
主要成果:
- 尽管先前进行了多次腰部微隔膜切除术,但通过MRI确定了复发性圆盘.
- 患者的持续疼痛表明了潜在的结构异常.
- 建议对SCS进行进一步的外科干预 (脊髓融合).
结论:
- 全面的成像和临床评估对于识别疼痛加剧的结构异常至关重要.
- 要确定SCS候选人,需要进行个性化评估.
- 在治疗慢性腰部疼痛方面,需要仔细考虑成像模式,特别是在有失败背部手术史的患者中.
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