지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2013.1
- 수록면
- 658 - 667 (10page)
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초록· 키워드
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Objective To compare the long-term effects and advantages of ultrasound (US)-guided selective cervical nerve root block with fluoroscopy (FL)-guided transforaminal block. Methods From March 2009 to November 2012, 162 patients received steroid injections for lower cervical radicular pain. A total of 114 patients fulfilled the inclusion criteria. All procedures were performed by using US or FL. We compared the intravascular injections during the procedure with the effects and functional scales at 3, 6, and 12 months after the procedure between the two groups. Successful treatments occurred when patients obtained significant pain reliefs (as measured by >50% improvements in the verbal numerical scale [VNS] score and >40% improvements in the neck disability index [NDI] score) and reported a patient satisfaction score of 3 or 4 points at 12 months after the injection. Image analysis of intravascular injection and chart review were performed. Logistic regression was performed to reveal the correlations between successful treatments and variables (patient’s age, gender, duration of the disease, cause, injection method, and radiologic finding).Results The VNS and NDI improved 3 months after the injection and continued to improve until 12 months for both groups. But there were no statistical differences in changes of VNS, NDI, and effectiveness between these two groups. The proportion of patients with successful treatment is illustrated as 62.5% in US-guided group and 58% in FL-guided group at 12 months. There were no significant differences between the groups or during follow-up periods. Three cases of the intravascular injections were done in FL-guided group.Conclusion The US-guided selective cervical nerve root blocks are facilitated by identifying critical vessels at unexpected locations relative to the foramen and to protect injury to such vessels, which is the leading cause of reported complications from FL-guided transforaminal blocks. On treatment effect, significant long-term improvements in functions and pain reliefs were observed in both groups after the intervention. However, significant differences were not observed between the groups. Therefore, the US-guided selective cervical nerve root block was shown to be as effective as the FL-guided transforaminal block in pain reliefs and functional improvements, in addition to the absence of radiation and protection vessel injury at real-time imaging.
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참고문헌 (26)
참고문헌 신청
Slipman CW. / 2002 / Therapeutic spinal corticosteroid injections for the management of radiculopathies / Phys Med Rehabil Clin N Am 1:697~711
Smuck M. / 2008 / Accuracy of intermittent fluoroscopy to detect intravascular injection during transforaminal epidural injections / Spine(Phila Pa 1976) 33:205~210
Baker R. / 2003 / Cervical transforaminal injection of corticosteroids into a radicular artery : a possible mechanism for spinal cord injury / Pain 103 : 211 ~ 215
Boswell MV. / 2003 / Epidural steroids in the management of chronic spinal pain and radiculopathy / Pain Physician 6 : 319 ~ 334
Derby R. / 2008 / Size and aggregation of corticosteroids used for epidural injections / Pain Med 9 : 227 ~ 234
Smuck M. / 2008 / Accuracy of intermittent fluoroscopy to detect intravascular injection during transforaminal epidural injections / Spine(Phila Pa 1976) 33:205~210
Baker R. / 2003 / Cervical transforaminal injection of corticosteroids into a radicular artery : a possible mechanism for spinal cord injury / Pain 103 : 211 ~ 215
Boswell MV. / 2003 / Epidural steroids in the management of chronic spinal pain and radiculopathy / Pain Physician 6 : 319 ~ 334
Derby R. / 2008 / Size and aggregation of corticosteroids used for epidural injections / Pain Med 9 : 227 ~ 234
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