腰椎小关节疼痛介入治疗中美专家共识(2024)

2024 Consensus Guidelines on Lumbar Facet Interventions Among Practicing Pain Physicians in China and the United States

慢性腰痛是一类严重影响患者生活质量的常见病症,其中由腰椎小关节紊乱导致的轴性腰痛(简称“腰椎小关节疼痛”)最为常见。介入治疗(诊断性阻滞和射频治疗)是腰椎小关节疼痛最有效且安全的治疗方法,但其临床安全性和技术细节目前仍缺乏明确的指导方针。为此,中美疼痛医学领域多位专家基于最新循证医学证据,共同制定了《腰椎小关节疼痛介入治疗中美专家共识(2024)》,旨在以患者为中心,以优化腰椎小关节疼痛介入治疗为目的,对患者选择、诊断性阻滞和标准射频技术的细节及注意事项及相关并发症提出专业建议,以期更好地指导临床实践。

Lumbar facet interventions,including facet joint injections,medial nerve blocks,and radio⁃frequency ablation(RFA),are prevalent treatments for low back pain(LBP).Despite their widespread use,debates persist regarding various aspects of these procedures.The 2024 Consensus Working Group on Lumbar Facet Interventions,composed of practicing pain physicians from both China and the United States,conducted an extensive review of the literature on the use of lumbar facet interventions in chronic pain management.Fol⁃lowing the U.S.Preventive Services Task Force grading guidelines,this consensus provides an evidence⁃based,patient⁃centered guideline tailored for pain physicians at all expertise levels for the management of chro⁃nic lower spinal pain.The guideline offers detailed recommendations on the identification of facetogenic pain,criteria for patient selection,the application of lumbar facet blocks and RFA techniques,and strategies for the prevention and management of intervention⁃related complications.