■本研究旨在就患者舒适度而言,比较矢状位椎板间(PS)和经椎间孔(TF)硬膜外类固醇注射对单侧L5和S1神经根下背痛的影响,功效,安全,对比度增强,和辐射暴露。
■这是一项前瞻性随机单盲研究。共有59名参与者参加了这项研究。获得视觉模拟量表(VAS)和Oswestry残疾指数(ODI)。对所有参与者进行了舒适问卷。记录总透视时间和造影剂分布水平。
■两组间治疗前和治疗后VAS评分相似。ODI评分在第2周增加,有利于PS组(P<0.041);然而,两组在其他时间没有差异.两组患者治疗后VAS和ODI评分均有显著改善(P<0.001)。PS组透视总时间较短(P<0.001)。PS应用更舒适(P<0.001)。PS组未出现并发症,TF组出现3种并发症。在PS组中57%的参与者中观察到硬膜外前造影剂扩散到三个或更多个水平,而在TF组中没有观察到超过两个水平的扩散。
■PS硬膜外方法在副作用发生率低方面优于TF方法,更少的辐射暴露,更好的患者舒适度,较高的硬膜外对比扩散,和单级针头访问。
UNASSIGNED: This study aimed to compare parasagittal interlaminar (PS) and transforaminal (TF) epidural steroid injections for unilateral L5 and S1 radicular lower back pain in terms of patient comfort, efficacy, safety, contrast enhancement, and radiation exposure.
UNASSIGNED: This was a prospective randomized single-blind study. A total of 59 participants were included in this study. The visual analog scale (VAS) and Oswestry Disability Index (ODI) were obtained. A comfort questionnaire was administered to all participants. The total fluoroscopy time and contrast distribution levels were recorded.
UNASSIGNED: Pre- and post-treatment VAS scores were similar between the groups. The ODI scores increased in favor of the PS group at week 2 (P < 0.041); however, there was no difference between the two groups at other times. The VAS and ODI scores improved significantly with treatment in both the groups (P < 0.001). Total fluoroscopy time was shorter in the PS group (P < 0.001). PS application was more comfortable (P < 0.001). While no complications were observed in the PS group, three complications occurred in the TF group. Anterior epidural contrast spread to three or more levels was observed in 57% of the participants in the PS group, whereas no spread to more than two levels was observed in the TF group.
UNASSIGNED: The PS epidural approach is superior to the TF approach in terms of a low incidence of side effects, less radiation exposure, better patient comfort, higher epidural contrast spread, and single-level needle access.