腰围外注选择的趋势:对从业者的偏好和实践模式的调查
Ryan Triglia1, Andrew Walrond1, Jesse Wagner1
1Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Interventional pain medicine
|July 17, 2025
概括
这项研究发现,症状表现,特别是根部疼痛,最能影响对腰部根部病变的跨外上神经注射的选择. 提供者培训和实践环境比临床场景复杂性更能预测技术选择.
科学领域:
- 疼痛医学 医学 疼痛医学
- 干预性疼痛管理 干预性疼痛管理
- 脊柱手术 脊柱手术 脊柱手术
背景情况:
- 腰椎激素病症影响到3%至5%的人口,通常是由脊柱狭窄症或椎间盘造成的.
- 外围注射类固醇注射对于那些对保守治疗没有反应的患者来说是一个常见的下一步.
- 尾巴,内膜和外膜是腰部外周腔空间的三个主要方法,在选择上没有明确的共识.
研究的目的:
- 调查培训,实践设置,准则遵守,位置和经验等因素如何影响外周注射方法偏好.
- 在疼痛管理专家中确定外围注射技术和类固醇药物的选择趋势.
主要方法:
- 一项调查分发给国际疼痛和脊柱干预协会 (IPSIS) 成员.
- 该调查包括人口统计问题和临床场景,图像检测结果以评估方法偏好.
- 受访者表示他们喜欢的注射类型和类固醇药物,有202名成员完成了调查.
主要成果:
- 在临床场景中,最常选择的是跨外形超神经的方法,特别是在L4-L5和L5-S1.1.
- 物理医学和康复 (PM&R) 经过培训的医生,在ACGME疼痛计划中接受过培训,并遵守IPSIS指南,倾向于这种方法.
- 德克萨米他是用于内膜内和外膜内外皮质类固醇注射的首选类固醇.
结论:
- 临床表现,特别是根部疼痛,强烈指导转肌上神经注射的选择,而不仅仅是成像.
- 德克萨米他的占主导地位的使用表明,在 epidural 类固醇注射中,以安全为重点的协议的趋势.
- 提供者培训和实践设置是决策的关键决定因素,强调需要持续教育.
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