PDF(Pubmed)
Abstract：
In Quebec, Canada, the public healthcare system offers free medical services. However, patients with spinal pain often encounter long waiting times for specialist appointments and limited physiotherapy coverage. In contrast, private clinics provide expedited care but are relatively scarce and entail out-of-pocket expenses. Once a patient with pain caused by a spinal disorder meets a pain medicine specialist, spinal intervention is quickly performed when indicated, and patients are provided lifestyle advice. Transforaminal epidural steroid injections are frequently administered to patients with radicular pain, and steroid injections are administered on a facet joint to control low back or neck pain. Additionally, medial branch blocks are performed prior to thermocoagulation. France\'s universal healthcare system ensures accessibility at controlled costs. It emphasizes physical activity and provides free physical therapy services. However, certain interventions, such as transforaminal and interlaminar epidural injections, are not routinely used in France owing to limited therapeutic efficacy and safety concerns. This underutilization may be a potential cause of chronic pain for many patients. By examining the differences, strengths, and weaknesses of these two systems, valuable insights can be gained for the enhancement of global spinal pain management strategies, ultimately leading to improved patient outcomes and satisfaction.
摘要：
在魁北克,加拿大,公共医疗系统提供免费医疗服务。然而,脊柱疼痛患者通常需要很长的等待专科医生预约时间和有限的理疗覆盖范围.相比之下,私人诊所提供快速护理，但相对稀缺，需要自付费用。一旦患有脊柱疾病引起的疼痛的患者遇到疼痛医学专家，脊柱介入在指示时迅速进行，并为患者提供生活方式建议。经椎间孔硬膜外类固醇注射常用于神经根疼痛患者，和类固醇注射在小关节上施用以控制下背部或颈部疼痛。此外,在热凝固之前进行内侧分支块。法国的全民医疗体系以可控的成本确保了可访问性。它强调身体活动并提供免费的物理治疗服务。然而,某些干预措施，如经椎间孔和层间硬膜外注射，由于有限的治疗效果和安全性问题，在法国不常规使用。这种利用不足可能是许多患者慢性疼痛的潜在原因。通过检查差异，优势,以及这两个系统的弱点，可以获得有价值的见解，以加强全球脊柱疼痛管理策略，最终改善患者的预后和满意度。
