좌골신경통에서 진단 및 치료를 위한 요추 신경근 주사의 효과
The Effect of Percutaneous Injection of Lumbar Nerve Roots in Diagnosis and Treatment of Sciatica
소속 상세정보
백운일/Woon Il Baek
이장철/이창영/손은익/김동원/임만빈/김인홍/Jang Chul Lee/Chang Lyung Lee/Eun Ik Son/Dong Won Kim/Man Bin Yim/In Hong Kim
KMID : 0359819970260040542
Abstract
요 약
저자들은 1995년 11월부터 1996년 8월까지 54명을 대상으로 요추 신경근 주사요법을 실시
한 후 그 결과를 분석하였다. 신경근 주사요법은 신경학적 진찰소견과 방사선학적 진단으로
정확한 진단이 힘들 경우 특히 과거에 수술한 경우나 여러 부위에 병변을 나타내고, 이때
증상을 나타내는 부위와 증상을 나타내지 않는 부위와의 감별이 쉽지 않을 경우에 증상을
유발하는 정확한 신경근을 찾음으로 해서 수술 결과를 향상시키는 진단적 가치가 있다. 또
한 수술 후 발생한 통증으로 여러 가지 통증 치료에서 증상 호전을 얻을 수 없던 환자의 경
우 고식적 치료의 한 방법으로서도 가능성이 있었다.
#초록#
Clinical evaluation and imaging studies such as magnetic resonance imaging, computed
tomography, and/or myelography can localize the pathologic process in most patients
with lumbar radiculopathy, However, these studies occasionally fail to demonstrate
exactly the cause and site for ongoing radicular symptom. So we evaluated 53 patients
for the efficacy of selective nerve root blocks to identify a symptomatic nerve. The
lumbar nerve root injections were performed at L3 root in 1 patients, at L4 root in 4
patients, at L5 root in 46 patients, and at S1 root in 3 patients. Among them, forty two
patients were done before operation (HNP 32 stenosis 5, spondylolisthesis 5), 9 patients
were done after operation due to poor results(root injury 2, infection 2, adhesion 1,
incorrect diagnosis 4), and 3 patients had improved radiculopathies following nerve root
injection(HNP 2, stenosis 1). The results of the nerve root injections and of the
operations were not affected by age and sex. There was a good correlation between the
response of the nerve root injection and the result of the operation(p<0.05). The
concentration of bupivacaine 0.5% has no additional effect comparing to
0.25%(70%/73/5%) solution in spite of its adverse effect causing transient motor
weakness. Additional use of depomedrol(50㎎) proved to be no more beneficial. Three
patients had improved symptoms for a long period after nerve root injection which
consequently lumbar nerve root injection can be used as a functional diagnostic tool to
predict operative result and as a treatment modality following failure of a previous
surgery.
키워드
Radiculopathy; Radioculography; HNP; Diagnosis; Nerve injection.;
원문 및 링크아웃 정보
등재저널 정보