术中背根神经节阻滞控制腰椎手术后疼痛综合征

Effect of intraoperative block of dorsal root ganglion on failed back surgery syndrome

目的探讨背根神经节内注射药物对控制腰椎手术后疼痛综合征(FBSS)的作用。方法69例腰椎间盘突出症患者行髓核摘除术,分为神经节阻滞组32例,鞘内注射0.75%布比卡因和地塞米松阻滞背根神经节;对照组37例,不作背根神经节阻滞。分别观察术后不同时间2组腰臀部和双下肢疼痛、VAS评分及受累神经根功能情况。结果神经节阻滞组药物止痛剂用量小、术后功能恢复快。对照组仍有部分患者存在术后近期疼痛。神经节阻滞组术后VAS评分明显低于对照组(P<0.05)。结论术中背根神经节阻滞能有效控制FBSS。

Objective To investigate the effect of drug injection into the dorsal root ganglia for failed back surgery syndrome（FBSS）.Methods 69 patients with lumbar disc herniation undergoing nucleus pulposus removal were randomly assigned to 2 groups.Ganglion block group（n=32） received intrathecal injection of 0.5 ml 0.75% bupivacaine and 2.5 mg dexamethasome to block the dorsal root ganglion.Control group（n=37） received no dorsal root ganglion block.The patients were evaluated for the pain in the waist and hip as well as the lower limbs,visual analogue scale（VAS） and the function of the nerve roots involved.Results The ganglion block group needed smaller dose of painkillers,with faster postoperative recovery of the functions,while in the control group,some patients still suffered from pain shortly after the operation.The VAS scores were markedly lower in ganglion block group than in the control group（P0.05）.Conclusion The intraoperative block of the dorsal root ganglion can effectively control FBSS.