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A shortened radiofrequency denervation method for cervical zygapophysial joint pain based on ultrasound localization of the nerves.

机译:一种基于神经超声定位的颈椎physi关节疼痛的简化射频去神经方法。

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OBJECTIVE: Radiofrequency neurotomy is a recognized treatment for cervical zygapophysial joint pain. In several studies, the method has provided complete pain relief in 60-70% of the patients for approximately 9 months. The validated technique has the disadvantage of procedural times of 2-4 hours because several lesions are performed to take into account the variable nerve course. We tested the hypothesis that ultrasound localization of the nerves would enable us to reduce the number of lesions performed, while reaching the benchmark of at least 80% pain relief in 80% of patients with a median duration of 35 weeks, as achieved by a previous investigation using the standard method. INTERVENTIONS: We prospectively studied 15 consecutive patients with diagnosed cervical zygapophysial joint pain. They were treated using a shortened radiofrequency procedure under fluoroscopic control, based on previous ultrasound localization of the joint supplying nerves, with only two thermal lesions performed per nerve. Successful treatment was defined as at least 80% pain relief in the visual analog scale as compared with pretreatment. Follow-up was performed until 12 months after treatment. RESULTS: Of the 15 patients, 14 were successfully treated (93%, 95% confidence interval [CI] 80-100%) with a median time of pain relief of 44 weeks. At 6 and 12 months, 13 (87%, 95% CI 70-100%) and 6 patients (40%, 95% CI 15-65%) reported successful treatment, respectively. The median duration of the procedure was 35 minutes. CONCLUSION: In patients with cervical zygapophysial joint pain, radiofrequency denervation according to a shortened protocol based on ultrasound localization of the nerves reached the benchmark of the standard technique.
机译:目的:射频神经切开术是公认的治疗颈physi突关节疼痛的方法。在几项研究中,该方法已为60-70%的患者提供了大约9个月的完全疼痛缓解。经过验证的技术的缺点是程序时间为2-4小时,因为要进行多次病变以考虑到可变的神经进程。我们检验了以下假设:神经的超声定位将使我们能够减少病变的数量,同时达到80%的中位持续时间为35周的患者中至少80%的疼痛缓解的基准,这一点以前使用标准方法进行调查。干预措施:我们前瞻性地研究了连续15例被诊断为颈突关节疼痛的患者。根据先前对关节供应神经的超声定位,在荧光镜控制下使用缩短的射频程序对其进行了治疗,每个神经仅进行了两次热损伤。成功的治疗定义为与治疗前相比,视觉模拟评分至少可减轻80%的疼痛。进行随访直至治疗后12个月。结果:在这15例患者中,有14例被成功治疗(93%,95%置信区间[CI] 80-100%),中位缓解时间为44周。在6个月和12个月时,分别有13例(87%,95%CI 70-100%)和6例患者(40%,95%CI 15-65%)报告成功治疗。该过程的中位时间为35分钟。结论:在颈突关节疼痛患者中,基于神经超声定位的缩短方案的射频去神经达到了标准技术的基准。

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