慢性腰痛患者接受内窥镜面神经支配术后的临床疗效

Maximilian Lenz, Philipp Egenolf, Johanna Menzhausen, Vincent Heck, Akanksha Perera, Peer Eysel, Max Scheyerer, Stavros Oikonomidis
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引用次数: 0

摘要

多项研究表明,腰背痛在人群中的发病率很高,高达 85%。经皮射频面神经支配术(PRFD)是当今治疗慢性腰背痛(CLBP)的黄金标准。然而,之前发表的研究对经皮射频面神经支配术的疗效存在争议。因此,本研究旨在分析使用内窥镜面关节去神经支配术(EFJD)治疗慢性腰背痛的情况,并找出可能限制手术适应症的潜在风险因素。所有患者均接受了 EFJD,术后必须完成 ODI、COMI、EQ-5D 和 VRS 评分,随访时间至少为 12 个月。我们发现所有临床评分,如 ODI、COMI、EQ-5D 和 VRS 评分都有显著改善。虽然 3 个月随访的效果最好,但在 12 个月随访时发现情况略有恶化。不过,与术前评分相比,患者还是明显受益。28/31 名患者(93.3%)在 12 个月的随访中表示疼痛减轻,并对手术表示满意。年龄较大和精神疾病先决条件被认为是与较差疗效相关的潜在风险因素。与术前至少有12个月CLBP的患者相比,EFJD的临床结果评分和VRS均有显著改善。老年患者和有精神疾病先决条件的患者似乎从该手术中获益较少。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical Outcome after Endoscopic Facet Denervation in Patients with Chronic Low Back Pain.

Several studies have reported that low back pain has a high prevalence among the population, with up to 85%. Percutaneous radiofrequency facet denervation (PRFD) is the gold standard of today's rhizotomy for chronic low back pain (CLBP). However, previously published studies present controversial results for the efficacy of PRFD. Therefore, this study aimed to analyse the use of endoscopic facet joint denervation (EFJD) to treat chronic low back pain and to identify potential risk factors that could limit indications for surgery.We retrospectively included 31 eligible patients into the study with at least 24 months of CLBP. All patients underwent EFJD and had to complete ODI, COMI, EQ-5D and VRS scores postoperatively, with a minimum follow up of 12 months. Basic patient data was recorded to analyse correlations.We found a significant improvement in all clinical scores measured, such as ODI, COMI, EQ-5D and VRS scores. While the best result was found at the 3 months follow-up, a slight deterioration was found at 12 months follow-up. However, significant benefit was observed when compared to preoperative scores. 28/31 patients (93.3%) reported reduced pain at 12 months follow-up and were satisfied with the procedure. Older age and psychiatric precondition were identified as potential risk factors associated with poorer outcome. Postoperative complications such as haematoma, a sensibility disorder and temporary low extremity muscular weakness were rarely observed.EFJD showed significant improvement of the clinical outcome scores and VRS when compared to preoperative results of patients, with a minimum of 12 months of CLBP prior to surgery. Older patients and patients with a psychiatric precondition seem to benefit less from the procedure.

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