John B. Smirniotopoulos MS, MD , Uchenna Osuala MS , Clark R. Restrepo MD , Junjian Huang MD
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引用次数: 0
摘要
慢性腰背痛是导致全球残疾的一个主要原因,但其病因往往很复杂,有多种致痛因素导致患者不适。前柱性腰痛涉及椎体和椎间盘,目前已知椎体终板是重要的疼痛源。继发于椎基底神经刺激的椎源性腰痛表现为轴向不适,前屈时加重,核磁共振成像上伴有 I 型或 II 型 Modic 改变。微创椎基底神经射频消融术已成为治疗前柱腰痛的有效干预方法。在本文中,作者介绍了一种通过图像引导椎基底神经消融术识别和治疗椎源性腰痛的综合方法。我们概述了患者的表现和诊断工作,随后提供了详细的程序指南,包括设备要求、技术执行以及潜在的技术挑战和并发症。
Chronic low back pain represents a leading cause of global disability, but can often be complex in etiology, with multiple pain generators contributing to patient discomfort. Anterior column low back pain involves the vertebral bodies and discs, with the vertebral body endplates now known to be a significant pain generator. Vertebrogenic low back pain secondary to irritation of the basivertebral nerve presents as axial discomfort, worse with forward flexion, and with concomitant Type I or II Modic changes on MRI. Minimally invasive basivertebral nerve radiofrequency ablation has emerged as an effective intervention for managing anterior column back pain. In this article, the authors present a comprehensive approach to identifying and treating vertebrogenic low back pain through image guided basivertebral nerve ablation. We outline the patient presentation and diagnostic workup, followed by a detailed procedural guide including equipment requirements, technique execution, and potential technical challenges and complications.
期刊介绍:
Interventional radiology is an area of clinical diagnosis and management that is highly technique-oriented. Therefore, the format of this quarterly journal, which combines the visual impact of an atlas with the currency of a journal, lends itself perfectly to presenting the topics. Each issue is guest edited by a leader in the field and is focused on a single clinical technique or problem. The presentation is enhanced by superb illustrations and descriptive narrative outlining the steps of a particular procedure. Interventional radiologists, neuroradiologists, vascular surgeons and neurosurgeons will find this a useful addition to the clinical literature.