CT引导下脊神经根周围注射术治疗颈肩与腰腿痛

CT-guided periradicular therapy in cervical and lumbar radicular syndromes

目的评价CT引导下经皮穿刺神经根周围注射术(PRT)治疗颈肩与腰腿痛的临床疗效。方法72例患者,均采用CT定位引导的方法进行PRT治疗术,穿刺到位后,在相应脊神经根出椎间孔处周围注射Triamhexal 10-20 mg和0．25％Carbostesin 3-4 ml,每周1次,共6次。结果72例患者,共进行了446例次的PRT治疗,穿刺均准确到位,Triamhexal及Carbostesin在神经根周围扩散分布良好,术后经6-24个月随访,62例显效,6例有效,4例无效,有效率达94．4％。未出现手术相关并发症。结论CT引导下的经皮穿刺神经根周围注射术,治疗难治性颈肩痛与腰腿痛,是一种高效、简便、安全的好方法。

Objective To evaluate the effectiveness of CT-guided periradlcular therapy （PRT） in cervical and lumber radicular syndromes. Methods Seventy two cases of cervical and lumbar radicular syndromes were treated by CT-guided PRT, During PRT, 10 - 20 mg of Triamhexal and 3 - 4 ml of Carbostesin 0.25%（Bupivacainhydrochlorid） were injected into the space around the corresponding spinal root, once a week, all together six times as a course. Results Four hundreds and forty six PRT procedures were carried out in 72 patients having a successful puncture and a satisfying spread of Triamhexal and Carbostesin around the spinal nerve root space for every time. After 6 to 24 months follow up, 62 patients showed a significant pain reduction or complete disappearance. Moderate improvement was not noted in 6 and no improvement in 4. The effective rate was 94.4% without any correlative complication. Conclusions CT-guided PRT is an effective, easy and safe procedure to treat patients with refractory cervical or lumbar radicular pain syndromes.