요천추 신경증에 의한 하지방사통의 미추경막외 주사 치료
Caudal Epidural Injection in Treatment of Lumbosacral Radicular Leg Pain
소속 상세정보
김일만/Il Man Kim
이장철/손은익/김동원/임만빈/김인홍/Jang Chull Lee/Eun Ik Son/Dong Won Kim/Man Bin Yim/In Hong Kim
KMID : 0359819990280010027
Abstract
결론
저자들은 최근 1년간 농촌지역에서 요추간판 탈출증, 요추강 협착증 및 요추에 전방전위
증등과 같은 퇴행성 요추 질환으로 인하여 요통과 하지 방사통을 호소하는 20명의 외래환자
를 대상으로 보다 적극적인 보존적 치료법의 일환으로 마취과의나 통증치료실에 의존하지
않고 직접 미추강내 스테로이드 및 국소마취제의 혼합액 주사요법을 실시하여 비교적 좋은
결과를 경험하였다. 본 시술은 비교적 손쉬운 수기로 큰 위험성 없이 안전하게 행할 수 있
으며 다른 보존적 치료법으로 효과가 없고 수술을 거부하거나 또는 적응이 되지 않는 심한
요통 및 좌골신경통 한자에서 고려해 볼 수 있을 것으로 사료된다.
#초록#
An spinal epidural injection is a relatively benign procedure and widely used for
symptomatic relief of back and radicular leg pain. The authors evaluated the efficacy of
caudal epidural injection with corticosteroids and local anesthetics which was performed
by a neurosurgeon for the treatment of ongoing lumbosacral radicula, symptoms.
Between July 1997 and June 1998, 20 patients with back pain and radiating leg pain
involving lumbosacral degenerative spine disease, who refused operation or were
unsuitable for general anesthesia, were treated and followed for more than 6 months. All
procedure was done under radiogaphical guidance aseptically. The authors used the
mixed solution of 1％ lidocaine(6 cases) or 0.25％ bupivacaine(14 cases) with
methylprednisolone acetate(1-2㎖). The mean total volume of the mixture was 15.6㎖.
The preoperative neurosurgical diagnosis included 11 lumbar disc herniation, 6 lumbar
stenosis and 3 spondylolisthesis and the involved nerve roots presenting with typical
radiculopathy were L5 root(17 patients). S1 root(15 patients), L4 root(4 patients), and S2
root(1 patient). The responses from patients were classified into 4 groups, and excellent
of good results with marked reduction on radicular leg pain were noted in 19 cases.
There were a few transient complications such as headache, leg numbness, perisacral
hypesthesia, injection pain, constipation and malpositioned spinal needle.
The authors suggest that the cadual epidural injections is a reasonable alternative to
spinal surgery if patient's pain is severe enough and you are exhausted other methods
to relieve the pain.
키워드
Pain; Lumbosacral radiculopathy; Caudal epidural injections; Steroid; Local anesthetics;
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