PDF(Pubmed)
Abstract：
Scapulalgia or shoulder pain accounts for 16% of all musculoskeletal complaints in the healthy adult population and becomes more common as we age. When this pain exceeds 3 months in duration, it is deemed to be chronic, and typically treated in an escalating manner. Spanning a continuum of conservative and non-conservative measures, chronic shoulder pain treatments range from rest and physical therapy to surgery. Since each patient presents with a unique spectrum of symptoms a customized treatment plan is often required. Over the lifetime of many of these patients, a variety of treatment options are required. One of these treatment options, peripheral nerve stimulation (PNS), is a minimally invasive procedure in which an electrical impulse is delivered through a percutaneously implanted, small caliber electrode to a peripheral nerve proximal to the lesion which interferes with the pain signals. Over the past several years, significant growth of PNS in the treatment of chronic neuropathic pain has been observed. However, the procedural techniques have not been well described. The foundation of long-term, minimally invasive percutaneous PNS in patients with chronic shoulder pain, and procedural techniques for stimulating the suprascapular and axillary nerves using fluoroscopy or ultrasonography will be described in this report.
摘要：
肩胛骨痛或肩痛占健康成年人群中所有肌肉骨骼疾病的16％，并且随着年龄的增长而变得越来越普遍。当这种疼痛持续时间超过3个月时，它被认为是慢性的，通常以逐步升级的方式处理。跨越保守和非保守措施的连续体，慢性肩痛的治疗范围从休息和物理治疗到手术。由于每个患者都表现出独特的症状谱，因此通常需要定制的治疗计划。在这些患者的一生中，需要多种治疗方案。这些治疗选择之一，周围神经刺激（PNS），是一种微创手术，其中电脉冲通过经皮植入，小口径电极连接到病变附近的周围神经，干扰疼痛信号。在过去的几年里，已观察到PNS在治疗慢性神经性疼痛中的显着增长。然而,程序技术没有得到很好的描述。长期的基础，微创经皮PNS治疗慢性肩痛,本报告将介绍使用透视或超声检查刺激肩胛骨上和腋下神经的手术技术。
