1. Lumbosacral radicular pain.

Autor: Peene L; Department of Anesthesiology, Intensive Care, Emergency Medicine and Multidisciplinary Pain Center, Ziekenhuis Oost-Limburg, Genk/Lanaken, Belgium., Cohen SP; Pain Medicine Division, Department of Anesthesiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA., Kallewaard JW; Department of Anesthesiology and Pain Medicine, Rijnstate Ziekenhuis, Velp, The Netherlands.; Anesthesiology and Pain Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands., Wolff A; Department of Anesthesiology UMCG Pain Center Groningen, University of Groningen, Groningen, The Netherlands., Huygen F; Department of Anesthesiology and Pain Medicine, Erasmusmc, Rotterdam, The Netherlands.; Department of Anesthesiology and Pain Medicine, University Medical Center Utrecht, Utrecht, The Netherlands., Gaag AV; Department of Anesthesiology and Pain Medicine, Catharina Ziekenhuis, Eindhoven, The Netherlands., Monique S; Anesthesiology and Pain Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands., Vissers K; Department of Anesthesiology, Pain and Palliative Medicine, Radboud University, Nijmegen, The Netherlands., Gilligan C; Department of Anesthesiology and Pain Medicine, Brigham & Women's Spine Center, Boston, Massachusetts, USA., Van Zundert J; Department of Anesthesiology, Intensive Care, Emergency Medicine and Multidisciplinary Pain Center, Ziekenhuis Oost-Limburg, Genk/Lanaken, Belgium.; Department of Anesthesiology and Pain Medicine, Maastricht University Medical Center, Maastricht, The Netherlands., Van Boxem K; Department of Anesthesiology, Intensive Care, Emergency Medicine and Multidisciplinary Pain Center, Ziekenhuis Oost-Limburg, Genk/Lanaken, Belgium.; Department of Anesthesiology and Pain Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.
Jazyk: angličtina
Zdroj: Pain practice : the official journal of World Institute of Pain [Pain Pract] 2024 Mar; Vol. 24 (3), pp. 525-552. Date of Electronic Publication: 2023 Nov 20.
DOI: 10.1111/papr.13317
Abstrakt: Introduction: Patients suffering lumbosacral radicular pain report radiating pain in one or more lumbar or sacral dermatomes. In the general population, low back pain with leg pain extending below the knee has an annual prevalence that varies from 9.9% to 25%.
Methods: The literature on the diagnosis and treatment of lumbosacral radicular pain was reviewed and summarized.
Results: Although a patient's history, the pain distribution pattern, and clinical examination may yield a presumptive diagnosis of lumbosacral radicular pain, additional clinical tests may be required. Medical imaging studies can demonstrate or exclude specific underlying pathologies and identify nerve root irritation, while selective diagnostic nerve root blocks can be used to confirm the affected level(s). In subacute lumbosacral radicular pain, transforaminal corticosteroid administration provides short-term pain relief and improves mobility. In chronic lumbosacral radicular pain, pulsed radiofrequency (PRF) treatment adjacent to the spinal ganglion (DRG) can provide pain relief for a longer period in well-selected patients. In cases of refractory pain, epidural adhesiolysis and spinal cord stimulation can be considered in experienced centers.
Conclusions: The diagnosis of lumbosacral radicular pain is based on a combination of history, clinical examination, and additional investigations. Epidural steroids can be considered for subacute lumbosacral radicular pain. In chronic lumbosacral radicular pain, PRF adjacent to the DRG is recommended. SCS and epidural adhesiolysis can be considered for cases of refractory pain in specialized centers.
(© 2023 The Authors. Pain Practice published by Wiley Periodicals LLC on behalf of World Institute of Pain.)
Databáze: MEDLINE
Externí odkaz: