Percutaneous Foraminal Neuroplasty Using Reference Spinal Needles: Technical Description.

IF 4.1 2区医学 Q1 CLINICAL NEUROLOGY

Pain and Therapy Pub Date : 2024-08-01 Epub Date: 2024-05-15 DOI:10.1007/s40122-024-00607-4

Victor M Silva-Ortiz, Alaa Abd-Elsayed, Jesus Medina-Razcon, Christopher L Robinson

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引用次数: 0

Abstract

Background: Lumbar foraminal stenosis is a common cause of chronic lower back pain and radiculopathy often treated by epidural steroid injections. In the absence of imaging findings with a positive physical exam demonstrating symptoms, percutaneous neuroplasty (PNP) may be an alternative to transforaminal epidural steroid injections that have otherwise failed.

Case presentation: We present two cases (55-year-old man and 65-year-old woman) with chronic low back pain and radiculopathy with otherwise normal imaging demonstrating no lumbar foraminal stenosis refractory to transforaminal epidural steroid injections. PNP was performed using reference spinal needles with both patients achieving sustained > 50-75% pain relief.

Conclusion: PNP offers interventional chronic pain physicians and patients with refractory chronic low back pain with lumbar radiculopathy due to fibrosis an alternative, safe treatment that offers sustained results. Furthermore, this is the first of its kind to offer a step-by-step procedural step of PNP using a reference spinal needle.

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使用参考脊柱针的经皮椎孔神经成形术：技术说明。

背景：腰椎椎间孔狭窄症是慢性下背痛和神经根病的常见原因，通常采用硬膜外类固醇注射治疗。在没有影像学检查结果而体格检查显示症状阳性的情况下，经皮神经成形术（PNP）可以替代经椎间孔硬膜外类固醇注射：我们介绍了两个病例（55 岁男性和 65 岁女性），他们患有慢性腰痛和根性神经病，影像学检查显示腰椎椎管狭窄，但经穿孔硬膜外类固醇注射无效。使用参考脊柱针进行 PNP 治疗后，两名患者的疼痛缓解率均持续大于 50-75%：结论：PNP 为慢性疼痛介入医生和因纤维化导致腰椎根病的难治性慢性腰痛患者提供了一种可替代的、安全的、可持续的治疗方法。此外，这也是首例使用参考脊髓穿刺针逐步进行 PNP 治疗的同类手术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pain and Therapy CLINICAL NEUROLOGY-

CiteScore

6.60

自引率

5.00%

发文量

110

审稿时长

6 weeks

期刊介绍： Pain and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of pain therapies and pain-related devices. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, acute pain, cancer pain, chronic pain, headache and migraine, neuropathic pain, opioids, palliative care and pain ethics, peri- and post-operative pain as well as rheumatic pain and fibromyalgia. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports, trial protocols, short communications such as commentaries and editorials, and letters. The journal is read by a global audience and receives submissions from around the world. Pain and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.