与骶髂关节注射相关的潜在 S1 神经根阻滞。

IF 2.5 3区 医学 Q2 CLINICAL NEUROLOGY
Pain Research & Management Pub Date : 2024-07-30 eCollection Date: 2024-01-01 DOI:10.1155/2024/8064804
Andrew Ng, Jesse Lou, Dajie Wang
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引用次数: 0

摘要

背景:骶髂关节(SI)功能障碍是下背部疼痛的常见原因。骶髂关节疼痛的诊断仍然具有挑战性。骶髂关节注射仍是诊断 SI 关节痛的金标准,并能提供治疗效果。骶髂关节注射的并发症之一是暂时性腿部麻木和无力:评估骶髂关节的解剖结构和对比剂在骶髂关节内的流动情况,了解局麻药如何影响神经根并导致暂时性腿部无力和麻木。研究设计。回顾性病例系列。地点: 学术医疗中心。学术医疗中心:通过回顾性审查电子病历中两名医疗人员的病例记录,确定接受了带透视的三维锥形束计算机断层扫描(3D-CBCT)成像的 SI 关节注射的患者。结果显示:27/32 名患者的平均年龄为 56 岁(39-87 岁),其中女性 20 人,男性 7 人。锥形束 CT 图像显示,4/27(14.8%)例患者的 SI 关节出现造影剂扩散,并扩散至 S1 后神经孔。其余 23/27 例(85.2%)患者的造影剂局限于 SI 关节。局限性。人群规模小,回顾性审查医疗记录:我们的研究结果表明,要降低 S1 神经根阻滞和硬膜外阻滞的风险,可能需要注射较低浓度、较少容量的局麻药。此外,为了提高诊断性 SI 注射的特异性,应考虑进行适当的评估,以排除任何 S1 神经病变作为重要的疼痛诱因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Potential S1 Nerve Root Blocks Associated with Sacroiliac Joint Injections.

Background: Sacroiliac (SI) joint dysfunction is a common cause of lower back pain. The diagnosis of SI joint pain remains challenging. Sacroiliac joint injection remains the gold standard of diagnosis of SI joint pain as well as providing therapeutic effect. One complication related to SI joint injection is temporary numbness and weakness of the leg.

Objectives: To evaluate the anatomy of the SI joint and the flow of the contrast in the sacroiliac joint and to understand how local anesthetic can affect the nerve roots and cause temporary weakness and numbness of the leg. Study Design. Retrospective case series. Setting. Academic medical center.

Methods: Patients who underwent SI joint injection with three-dimensional cone beam computed tomography with fluoroscopy (3D-CBCT) imaging were identified through retrospective review of two providers' case log from the electronic medical record. The cone beam CT images were reviewed to study the contrast spread and flow in the SI joint.

Results: 27/32 patients with the mean age of 56 years (range 39-87 years), 20 females, and 7 males were included in this study. After reviewing cone beam CT images, 4/27 (14.8%) patients showed contrast spread in the SI joint and spread into the S1 posterior neuroforamen. The remainder 23/27 (85.2%) patients had contrast localized in the SI joint. Limitations. Small population size, retrospective review of medical records.

Conclusion: Our results indicate that the injection of lower concentration of local anesthetic with less volume may be necessary to decrease the risk of S1 nerve root block and epidural block. Furthermore, to improve the specificity of a diagnostic SI injection, an appropriate evaluation should be considered to rule out any S1 nerve pathology as a significant pain generator.

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来源期刊
Pain Research & Management
Pain Research & Management CLINICAL NEUROLOGY-
CiteScore
5.30
自引率
0.00%
发文量
109
审稿时长
>12 weeks
期刊介绍: Pain Research and Management is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies in all areas of pain management. The most recent Impact Factor for Pain Research and Management is 1.685 according to the 2015 Journal Citation Reports released by Thomson Reuters in 2016.
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