对于由于椎间盘的宫根性疼痛进行核整形术
Judith D de Rooij1, Arianne P Verhagen2,3, B S Harhangi4,5
1Pain Treatment Center, Erasmus Medical Center, Rotterdam, Netherlands.
The Cochrane database of systematic reviews
|November 26, 2025
概括
与保守治疗相比,核塑性手术可能会显著减少椎根性疼痛患者的疼痛,但对其对功能和其他比较的影响的证据有限. 需要更多高质量的研究来确认它的好处和安全性.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 最少侵入性手术的方法
- 疼痛管理 疼痛管理
背景情况:
- 宫根部疼痛,通常是由椎间盘造成的,导致部和手臂疼痛,有潜在的软弱或感官变化.
- 保守治疗包括休息,药物治疗和物理治疗,但如果这些失败,可以考虑手术.
- 核形成术是一种微创的门诊手术,旨在通过切除部分磁盘核来减轻神经压力.
研究的目的:
- 为了评估核塑性治疗椎根性疼痛的疗效.
- 为了比较核整形与安慰剂,没有治疗,保守的护理,其他最少的侵入性技术和手术.
- 评估结果,包括疼痛,功能,生活质量,恢复和不良事件.
主要方法:
- 进行了随机对照试验 (RCT) 的系统审查.
- 在多个数据库和试验注册表中进行了搜索,直到2025年2月.
- 包括四个涉及259名参与者的RCT,使用Cochrane工具评估偏差风险,使用GRADE评估证据确定性.
主要成果:
- 与保守治疗相比,核塑造显示出低确定性证据表明显著减少疼痛,但在短期随访时部功能没有差异.
- 将核塑性与脉冲射频或椎间盘切除术进行比较的证据确定性低至非常低,表明对疼痛,功能,恢复和不良事件的影响不确定.
- 没有发现RCT将核塑性与安慰剂或没有治疗进行比较;所有纳入的研究都有高偏差风险.
结论:
- 目前的低确定性证据表明,与保守治疗相比,核塑性手术可能有效地减少椎根性疼痛的疼痛,但其对功能的影响尚不清楚.
- 由于研究的质量低和数量有限,没有足够的证据来支持核整形而不是其他干预措施,如脉冲射频或椎间盘切除术.
- 高质量,精心设计的随机对照试验是必要的,以确定核塑性治疗椎根性疼痛的真正有效性和安全性.
相关概念视频
01:21Imaging Studies for Cardiovascular System IV: CMRI
541
Cardiovascular magnetic resonance imaging, or CMRI, is a non-invasive diagnostic test that employs a magnetic field and radiofrequency waves to create precise images of the heart and arteries. It provides comprehensive information about cardiac anatomy, function, perfusion, and tissue characterization without ionizing radiation.IndicationsCMRI diagnoses various heart conditions, including tissue damage from heart attacks, ischemic heart disease, myocarditis, aortic issues (tears, aneurysms,...
541
01:29Herniated Intervertebral Disc l: Introduction
40
Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...
40
01:23Degenerative Disc Disease ll: Pathophysiology
30
The symptoms of degenerative disc disease arise from a combination of mechanical compression, vascular compromise, and biochemical inflammation, which together disrupt nerve function and produce pain.Mechanical CompressionDisc degeneration reduces height and elasticity, predisposing to herniation of the nucleus pulposus, a major cause of radicular pain. Herniations may be protrusion (bulging with intact annulus), extrusion (nucleus extends beyond disc but remains connected), or sequestration...
30