磁共振成像引导下的神经溶解术治疗慢性难治性膝关节疼痛:病例报告。

IF 1.9 3区 医学 Q2 ORTHOPEDICS Skeletal Radiology Pub Date : 2024-11-12 DOI:10.1007/s00256-024-04819-9
Alexander W Marka, Maximillian Strenzke, Kilian Weiss, Dimitrios C Karampinos, Klaus Woertler, Mirco Herbort, Nima Befrui, Tom Finck
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引用次数: 0

摘要

慢性难治性疼痛是膝关节病变的一个重大挑战,尤其是在用尽保守、关节镜和假体内固定治疗方案之后。本病例报告展示了一种创新方法,即利用核磁共振辅助下的膝神经化学溶解术来治疗关节镜手术后的顽固性膝关节疼痛。一位 62 岁的男性患者患有慢性难治性膝关节疼痛,疼痛主要集中在膝关节内侧,他接受了高分辨率核磁共振成像检查,以观察膝状神经。这样就可以对膝内侧神经进行有针对性的乙醇神经溶解。术后,患者在 4 个月的随访期间疼痛明显减轻。核磁共振成像辅助化学神经溶解术的成功应用为难治性膝关节疼痛患者提供了一种前景广阔的替代治疗方法,可提供持久的疼痛缓解,且无重大副作用。这项技术有可能改善慢性膝关节疼痛患者的生活质量。虽然这些初步结果令人鼓舞,但必须指出的是,还需要进一步的研究,包括短期和长期研究以及随机对照试验,以确定这种治疗方法在更广泛人群中的有效性和安全性,然后才能考虑将其常规纳入疼痛治疗实践中。
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MRI-guided neurolysis for the treatment of chronic refractory knee pain: a case report.

Chronic refractory pain poses a significant challenge in knee joint pathologies, especially after exhaustion of conservative, arthroscopic, and endoprosthetic therapy options. This case report illustrates an innovative approach using MRI-assisted chemical neurolysis of a genicular nerve to manage persistent knee pain after arthroscopy. A 62-year-old male patient with chronic refractory knee pain, primarily localized at the inferomedial part of the knee, underwent high-resolution MRI to visualize the genicular nerves. This allowed for targeted ethanol-based neurolysis of the inferomedial genicular nerve. Following the procedure, the patient experienced substantial pain reduction for the follow-up duration of 4 months. The successful use of MRI-assisted chemical neurolysis offers a promising alternative treatment for patients with refractory knee pain, providing long-lasting pain relief without major side effects. This technique has the potential to improve the quality of life for patients suffering from chronic knee pain While these initial results are encouraging, it is important to note that further research, including both short-term and long-term studies, as well as randomized controlled trials, is warranted to establish the efficacy and safety of this treatment method in broader populations before it can be considered for routine incorporation into pain management practices.

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来源期刊
Skeletal Radiology
Skeletal Radiology 医学-核医学
CiteScore
4.40
自引率
9.50%
发文量
253
审稿时长
3-8 weeks
期刊介绍: Skeletal Radiology provides a forum for the dissemination of current knowledge and information dealing with disorders of the musculoskeletal system including the spine. While emphasizing the radiological aspects of the many varied skeletal abnormalities, the journal also adopts an interdisciplinary approach, reflecting the membership of the International Skeletal Society. Thus, the anatomical, pathological, physiological, clinical, metabolic and epidemiological aspects of the many entities affecting the skeleton receive appropriate consideration. This is the Journal of the International Skeletal Society and the Official Journal of the Society of Skeletal Radiology and the Australasian Musculoskelelal Imaging Group.
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