하부 경추의 방사통 환자에서 초음파를 이용한 선택적 신경근 차단술의 효과 = 지속성과 부작용 평가

국문 초록 (Abstract)

목적: 하부 경추의 디스크 병변으로 인한 상지 방사통을 호소하는 환자들을 대상으로 초음파를 이용한 선택적 신경근 차단술을 시행하여 그 효과의 지속성과 부작용에 대하여 평가해 보고자 하였다.
대상 및 방법: 2014년 2월부터 2016년 2월까지 경추 추간판 탈출증으로 인한 상지 방사통을 주소로 내원한 환자들 60명 중 39명에게 초음파 유도하 선택적 신경근 차단술을 시행하였다. 시술의 효과 및 지속성을 평가하기 위하여 시술 전, 후 및 3개월째 통증의 호전 정도와 기능적 향상 정도를 조사하였다. 연성 추간판(soft disc)군과 경성 추간판(hard disc)군 2개 군으로 나누어 비교하였으며 시술 과정과 직후, 다음날까지 발생한 부작용을 조사하여 시술의 안전성을 평가해 보았다.
결과: 통증의 호전 정도를 평가한 시각통증척도는 평균 6.00에서 시술 후 평균 3.02로 호전되었고 Neck Disability Index 또한 평균 15.82에서 6.15로 향상된 결과를 보였다(p＜0.05). 시술 후 2예에서 두통, 2예에서 어지러움 등의 일시적인 부작용을 보였으나 1시간 내로 호전되었으며 시술 다음날까지 지속되는 부작용은 없었다. 32명(82.1%)의 환자에서 시술 후 통증의 호전이 있었으며, 그 중 24명의 경우 통증 호전이 3개월 이상 지속되었다. 7명(17.9%)의 환자에서는 시술 후 전혀 증상의 호전이 없었으며 1개월 이내에 통증의 악화나 증상이 재발한 환자는 6명(15.4%)이었다. 연성 추간판군에서 시술 전 5.88, 12주 후 2.64로 통증 감소 효과를 보였고(p＜0.01). 경성 추간판군에서 시술 전 6.09, 12주 후 3.22로 통증 감소 효과를 확인할 수 있었다(p＜0.01). 그러나 두 군 사이의 유의한 차이는 확인할 수 없었다.
결론: 경추부 디스크로 인한 신경근증 환자에서 초음파를 이용한 경추의 선택적 신경근 차단술은 효과적이며 중대한 합병증의 가능성이 낮아 외래 환자를 대상으로 사용해 볼 수 있는 좋은 치료 방법 중에 하나로 생각된다.

다국어 초록 (Multilingual Abstract)

Purpose: The purpose of this study was to evaluate the sustainability and adverse effects of ultrasound-guided selective nerve root block in patients who complained of radiculopathy due to lower cervical disc herniation.
Materials and Methods: Between February 2014 and February 2016, 39 out of 60 patients who visited Department of Orthopedic Surgery, Kosin University Gospel Hospital with a chief complaint of radiculopathy due to lower cervical disc herniation were treated with an ultrasound-guided selective nerve root block. To evaluate the efficacy and sustainability of this treatment, the degree of pain relief and functional improvement were evaluated before and 3 months after the procedure. Patients were categorized into two groups: The soft disc group and the hard disc group. The safety of the procedure was evaluated by examining the side effects occurring immediately after the procedure and the following day.
Results: Visual analogue scale and Neck Disability Index were improved from 6.00 to 3.02 and from 15.82 to 6.15, respectively (p＜0.05). There were 2 cases of headache and 2 cases of dizziness; however, they were resolved within 1 hour after the procedure. In 32 patients (82.1%), there was improvement in pain, which persisted for more than 3 months in 24 patients. Contrastinly, 7 patients (17.9%) showed no improvement and 6 patients (15.4%) experienced recurrence of pain or symptoms within 1 month after the procedure. In the soft disc group, there was a reduction in pain, from a score of 5.88 before the procedure to 2.64 twelve weeks after the procedure (p＜0.01). In the hard disc group, there was also a reduction in, from a score of 6.09 before the procedure to 3.22 at postoperative 12 weeks (p＜0.01). There was no significant difference between the two groups.
Conclusion: In patients with cervical disc herniation, an ultrasound-guided selective nerve root block appears to be an effective treatment option for outpatients due to its low risk of serious complications.

목차 (Table of Contents)

• 서론
• 대상 및 방법
• 결과
• 고찰
• 결론
• REFERENCES

참고문헌 (Reference)

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